Individual
DIANA GANTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
11301 SE10TH ST, APT 206, VANCOUVER, WA 98664
(706) 414-3342
Mailing address
11301 SE10TH ST, APT 206, VANCOUVER, WA 98664
(706) 414-3342
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6583
OR
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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