Provider Demographics
NPI:1255820395
Name:WHELCHEL, SHARAYAH JUNG (PT, DPT, CLT)
Entity type:Individual
Prefix:DR
First Name:SHARAYAH
Middle Name:JUNG
Last Name:WHELCHEL
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 CHESTNUT STATION CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-6395
Mailing Address - Country:US
Mailing Address - Phone:800-335-1060
Mailing Address - Fax:
Practice Address - Street 1:1376 SILVER SPRINGS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-2319
Practice Address - Country:US
Practice Address - Phone:859-277-0320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist