Provider Demographics
NPI:1366142846
Name:GILLENTINE, ELIZABETH WOODLEY (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WOODLEY
Last Name:GILLENTINE
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 1:1305 NAVAHO DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7467
Mailing Address - Country:US
Mailing Address - Phone:843-812-7099
Mailing Address - Fax:
Practice Address - Street 1:34 WHITE BRIDGE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1473
Practice Address - Country:US
Practice Address - Phone:843-812-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist