Provider Demographics
NPI:1033589031
Name:CHEN, YI JU (DPT)
Entity Type:Individual
Prefix:MS
First Name:YI JU
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SEVEN LOCKS ROAD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:301-217-0515
Mailing Address - Fax:301-217-0585
Practice Address - Street 1:1201 SEVEN LOCKS ROAD
Practice Address - Street 2:SUITE 212
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854
Practice Address - Country:US
Practice Address - Phone:301-217-0515
Practice Address - Fax:301-217-0585
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist