Provider Demographics
NPI:1326280702
Name:KO, CHERRIE ANN DALOCANOG (PT)
Entity Type:Individual
Prefix:MS
First Name:CHERRIE ANN
Middle Name:DALOCANOG
Last Name:KO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHERRIE ANN
Other - Middle Name:DY
Other - Last Name:DALOCANOG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4071 N DIXIE HWY
Mailing Address - Street 2:APT 31
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3077
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4071 N DIXIE HWY
Practice Address - Street 2:APT 31
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3077
Practice Address - Country:US
Practice Address - Phone:954-607-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist