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General NPI Number Information
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NPI Number | 1578488508
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Entity Type | Individual
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Provider Name | MR. TIMOTHY CHA
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Gender | Male
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 3056 S KINNICKINNIC AVE STE 302
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City | MILWAUKEE
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State | WI
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Zip | 53207-1103
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Country | US
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Telephone | 414-326-2660
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Fax |
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Provider Business Mailing Address
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Address Line | N83W13704 FOND DU LAC AVE APT 20
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-7246
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Country | US
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Telephone | 414-839-0735
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | WI
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