Provider Demographics
NPI:1043382799
Name:CHUA, SEAN RAYMUND COLON (PT)
Entity Type:Individual
Prefix:MR
First Name:SEAN RAYMUND
Middle Name:COLON
Last Name:CHUA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6709 S PEWTER WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-7268
Mailing Address - Country:US
Mailing Address - Phone:480-235-0362
Mailing Address - Fax:480-304-3282
Practice Address - Street 1:6709 S PEWTER WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-7268
Practice Address - Country:US
Practice Address - Phone:480-235-0362
Practice Address - Fax:480-304-3282
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7028225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist