Provider Demographics
NPI:1417169129
Name:KHO, JULIETA CHING (PT, AP, DOM)
Entity Type:Individual
Prefix:
First Name:JULIETA
Middle Name:CHING
Last Name:KHO
Suffix:
Gender:F
Credentials:PT, AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 6TH AVE
Mailing Address - Street 2:UNIT 16-A
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5900
Mailing Address - Country:US
Mailing Address - Phone:772-562-2948
Mailing Address - Fax:
Practice Address - Street 1:1600 26TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3330
Practice Address - Country:US
Practice Address - Phone:772-713-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2138171100000X
FLPT 9188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist