Provider Demographics
NPI:1275118515
Name:CHILCOTT, SHARON ELIZABETH (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ELIZABETH
Last Name:CHILCOTT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 TROUPE RD
Mailing Address - Street 2:
Mailing Address - City:HARBORCREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16421-1015
Mailing Address - Country:US
Mailing Address - Phone:814-460-4728
Mailing Address - Fax:
Practice Address - Street 1:2307 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4539
Practice Address - Country:US
Practice Address - Phone:814-528-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI002513225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant