Provider Demographics
NPI:1043090772
Name:VILLALVA, ANA LAURA SANTANNA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANA LAURA
Middle Name:SANTANNA
Last Name:VILLALVA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BRIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37090-2073
Mailing Address - Country:US
Mailing Address - Phone:615-679-6162
Mailing Address - Fax:
Practice Address - Street 1:1647 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3153
Practice Address - Country:US
Practice Address - Phone:615-461-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist