Provider Demographics
NPI:1487824298
Name:DIUMBERTO, ALAINA MARIE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:ALAINA
Middle Name:MARIE
Last Name:DIUMBERTO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:ALAINA
Other - Middle Name:MARIE
Other - Last Name:DIUMBERTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:9 MAPLE TREE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4070
Mailing Address - Country:US
Mailing Address - Phone:864-286-8288
Mailing Address - Fax:864-286-8289
Practice Address - Street 1:9 MAPLE TREE CT
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4070
Practice Address - Country:US
Practice Address - Phone:864-286-8288
Practice Address - Fax:864-286-8289
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2202225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant