Individual
ANNABELLE LEE GANNAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9355 SAN JOSE BLVD, JACKSONVILLE, FL 32257-5503
(904) 739-0877
Mailing address
424 WALNUT CT, JACKSONVILLE, FL 32206-4643
(352) 459-6733
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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