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General NPI Number Information
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NPI Number | 1386872968
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Entity Type | Individual
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Provider Name | NIJAH M CHINN PT, MHA
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Gender | Female
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 300B TEMPLE LAKE DR SUITE 1
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2973
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Country | US
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Telephone | 804-524-9036
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Fax | 804-524-9039
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Provider Business Mailing Address
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Address Line | 771 PILOT HOUSE DR
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-1990
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Country | US
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Telephone | 757-873-2302
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Fax | 757-873-2306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305005030
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License Number State | VA
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