Provider Demographics
NPI:1629220157
Name:WANG, CHING-HAN (MSPT)
Entity Type:Individual
Prefix:
First Name:CHING-HAN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14205 PARK CENTER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5252
Mailing Address - Country:US
Mailing Address - Phone:301-853-0093
Mailing Address - Fax:301-853-0096
Practice Address - Street 1:14205 PARK CENTER DR STE 204
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5252
Practice Address - Country:US
Practice Address - Phone:301-853-0093
Practice Address - Fax:301-853-0096
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204612225100000X
MD24403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist