Basic Information
Provider Information
NPI: 1184254526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TONDO
FirstName: MARIANA
MiddleName: HANNA
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 800 CRESCENT CENTRE DR STE 300
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370677285
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 921 GALLATIN AVE STE 102
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372063272
CountryCode: US
TelephoneNumber: 6297771520
FaxNumber: 6297771521
Other Information
ProviderEnumerationDate: 01/24/2020
LastUpdateDate: 02/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 02/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X12321TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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