Provider Demographics
NPI:1487228441
Name:CHUA, SHERYL WEN JING (DPT)
Entity Type:Individual
Prefix:
First Name:SHERYL WEN JING
Middle Name:
Last Name:CHUA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 MCCLENNAN CT N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4573
Mailing Address - Country:US
Mailing Address - Phone:415-996-8620
Mailing Address - Fax:
Practice Address - Street 1:2353 MCCLENNAN CT N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4573
Practice Address - Country:US
Practice Address - Phone:415-996-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05014155A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist