Provider Demographics
NPI:1942635354
Name:ALMILLA, DIANNE O'NNEIL GELANGRE (PT)
Entity Type:Individual
Prefix:
First Name:DIANNE O'NNEIL
Middle Name:GELANGRE
Last Name:ALMILLA
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 1:570 CHURCH ST E
Mailing Address - Street 2:APARTMENT 703
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4697
Mailing Address - Country:US
Mailing Address - Phone:615-457-3980
Mailing Address - Fax:
Practice Address - Street 1:105 WESTPARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5319
Practice Address - Country:US
Practice Address - Phone:615-377-9140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14308225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist