Provider Demographics
NPI:1437597168
Name:DELLINGER, LANA ALDEN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:ALDEN
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:ALDEN
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:101 STILLWATER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005
Mailing Address - Country:US
Mailing Address - Phone:478-293-1680
Mailing Address - Fax:478-293-1685
Practice Address - Street 1:101 STILLWATER CIRCLE
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005
Practice Address - Country:US
Practice Address - Phone:478-293-1680
Practice Address - Fax:478-293-1685
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist