Provider Demographics
NPI:1841527249
Name:CHIN, SHAWNTEL KIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SHAWNTEL
Middle Name:KIA
Last Name:CHIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15231 LIONS DEN RD
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-5601
Mailing Address - Country:US
Mailing Address - Phone:301-421-0898
Mailing Address - Fax:
Practice Address - Street 1:15231 LIONS DEN RD
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-5601
Practice Address - Country:US
Practice Address - Phone:301-421-0898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist