Provider Demographics
NPI:1912611716
Name:DIMALANTA, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:DIMALANTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38471 N SPITZ DR
Mailing Address - Street 2:
Mailing Address - City:BEACH PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60099-3317
Mailing Address - Country:US
Mailing Address - Phone:773-350-0506
Mailing Address - Fax:
Practice Address - Street 1:6450 S BOSTON ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5336
Practice Address - Country:US
Practice Address - Phone:303-224-9455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist