Provider Demographics
NPI:1952875551
Name:CHO, MINNA RENE (PTA)
Entity Type:Individual
Prefix:
First Name:MINNA
Middle Name:RENE
Last Name:CHO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 PARK OF COMMERCE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8248
Mailing Address - Country:US
Mailing Address - Phone:800-513-5641
Mailing Address - Fax:
Practice Address - Street 1:5112 GANDER RD W
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-4511
Practice Address - Country:US
Practice Address - Phone:937-542-1138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist