Provider Demographics
NPI:1275694457
Name:JENNIFER CHU, M.D.,LLC
Entity Type:Organization
Organization Name:JENNIFER CHU, M.D.,LLC
Other - Org Name:ETOIMS SOFT TISSUE COMFORT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-387-0550
Mailing Address - Street 1:3401 MARKET STREET
Mailing Address - Street 2:SUITE 135
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3315
Mailing Address - Country:US
Mailing Address - Phone:215-387-0550
Mailing Address - Fax:
Practice Address - Street 1:3401 MARKET ST
Practice Address - Street 2:SUITE 135
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3318
Practice Address - Country:US
Practice Address - Phone:215-387-0550
Practice Address - Fax:215-387-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036156L261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation