Individual
DYANNA COGSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20952 E 12 MILE RD STE 110, SAINT CLAIR SHORES, MI 48081-3202
(586) 498-3500
Mailing address
20952 E 12 MILE RD STE 110, SAINT CLAIR SHORES, MI 48081-3202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023088168
—
MI
Enumeration date
05/17/2018
Last updated
05/17/2018
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