Individual
DIANE GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
610 TEN ROD ROAD, WICKFORD CHIROPRACTIC AND WELLNESS CENTER, NORTH KINGSTOWN, RI 02852-6951
(401) 295-9767
(401) 295-0230
Mailing address
392 BUTTERNUT DR, NORTH KINGSTOWN, RI 02852-6951
(401) 295-9767
(401) 295-0230
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01319
RI
Other
Enumeration date
05/20/2006
Last updated
11/30/2009
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