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General NPI Number Information
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NPI Number | 1629885447
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Entity Type | Individual
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Provider Name | ISABELLE CHURAN
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1100 CIRCLE 75 PKWY SE
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City | ATLANTA
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State | GA
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Zip | 30339-3064
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Country | US
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Telephone | 518-527-3759
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Fax |
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Provider Business Mailing Address
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Address Line | 229 COOKSBORO RD
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City | TROY
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State | NY
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Zip | 12182-4029
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Country | US
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Telephone | 518-527-3759
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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