Provider Demographics
NPI:1497873673
Name:CHIPPS, ANN MICHELLE (PTA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELLE
Last Name:CHIPPS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MICHELLE
Other - Last Name:HYDUCHAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:26 RIDGE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1092
Mailing Address - Country:US
Mailing Address - Phone:302-399-7004
Mailing Address - Fax:
Practice Address - Street 1:2222 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-1805
Practice Address - Country:US
Practice Address - Phone:513-851-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0605144225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant