Provider Demographics
NPI:1184961567
Name:COSTIGAN-HUMES, CHLOE CORRINE (DPT)
Entity type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:CORRINE
Last Name:COSTIGAN-HUMES
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 1:934 MARCON BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-9598
Mailing Address - Country:US
Mailing Address - Phone:570-234-0283
Mailing Address - Fax:570-796-1854
Practice Address - Street 1:934 MARCON BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9598
Practice Address - Country:US
Practice Address - Phone:570-234-0283
Practice Address - Fax:570-796-1854
Is Sole Proprietor?:No
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist