MEDICARE: ANNETTE DINALLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	003121	OH

General Provider Information

NPI Number	:	1053731000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE DINALLO

Provider Business Mailing Address
First Line	:	6669 WILLOW LAKE DR
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4983
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 E ROYALTON RD
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-2840
Country	:	US
Telephone Number	:	440-717-1370
Fax Number	:	440-717-1520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	04/17/2014

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Directions to “ ANNETTE DINALLO ” Practice Location

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