Provider Demographics
NPI:1073092052
Name:GALVAN, NATALIA MARIEL (PT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:MARIEL
Last Name:GALVAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9571 ROBINSON FARM RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6880
Mailing Address - Country:US
Mailing Address - Phone:423-238-1127
Mailing Address - Fax:423-238-1277
Practice Address - Street 1:2020 GUNBARREL RD STE 408
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2663
Practice Address - Country:US
Practice Address - Phone:423-238-1127
Practice Address - Fax:423-238-1277
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty