Provider Demographics
NPI:1013240084
Name:CHEUNG, ALICE M (BS IN PHYSICAL THE)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:M
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:BS IN PHYSICAL THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9695 BASKET RING RD APT 4
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3434
Mailing Address - Country:US
Mailing Address - Phone:410-997-4308
Mailing Address - Fax:
Practice Address - Street 1:5330 DORSEY HALL DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7831
Practice Address - Country:US
Practice Address - Phone:410-772-5865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist