Provider Demographics
NPI:1316024680
Name:CHOU, KENT (PT)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:
Last Name:CHOU
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 1:111 CAMINO DE LAS CRUCITAS
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1541
Mailing Address - Country:US
Mailing Address - Phone:505-984-9101
Mailing Address - Fax:505-984-8998
Practice Address - Street 1:333 W CORDOVA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1850
Practice Address - Country:US
Practice Address - Phone:505-984-9101
Practice Address - Fax:505-984-8998
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist