Healthcare Provider Details

I. General information

NPI: 1053399428
Provider Name (Legal Business Name): WENDY M CHORNY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SUGAR CAMP CIR SUITE 221
OAKWOOD OH
45409-1962
US

IV. Provider business mailing address

83 N MILLER RD SUITE 202
FAIRLAWN OH
44333-3729
US

V. Phone/Fax

Practice location:
  • Phone: 937-227-3174
  • Fax: 937-227-3325
Mailing address:
  • Phone: 330-865-1600
  • Fax: 330-865-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011323
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: