Provider Demographics
NPI:1326702192
Name:CIELO, ZINNIA (PT)
Entity Type:Individual
Prefix:
First Name:ZINNIA
Middle Name:
Last Name:CIELO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ZINNIA
Other - Middle Name:
Other - Last Name:ZOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 HUNTERS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-8329
Mailing Address - Country:US
Mailing Address - Phone:423-975-2000
Mailing Address - Fax:
Practice Address - Street 1:505 N ROAN ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4740
Practice Address - Country:US
Practice Address - Phone:423-975-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4199OtherNONE