Individual
DIANA GANAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4132 DEVONSHIRE CT NE, SALEM, OR 97305-1982
(503) 364-5313
(503) 364-5296
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7715
OR
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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