Provider Demographics
NPI:1588684310
Name:CHAN, YUK HA GRACE (MSPT)
Entity Type:Individual
Prefix:MS
First Name:YUK HA
Middle Name:GRACE
Last Name:CHAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:YUK HA
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:433 CATHARINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3105
Mailing Address - Country:US
Mailing Address - Phone:215-825-6970
Mailing Address - Fax:215-825-6977
Practice Address - Street 1:433 CATHARINE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3105
Practice Address - Country:US
Practice Address - Phone:215-825-6970
Practice Address - Fax:215-825-6977
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012873L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist