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NPI Code Detail

MEDICARE: CARMEN CHONA ATC

MEDICARE: CARMEN CHONA ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerJ3-0000518DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1J3-0000518OTHERDEBOC

General Provider Information

NPI Number : 1184168510
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN CHONA ATC
Provider Business Mailing Address
First Line : 14712 WOODBRIDGE RD
Second Line :
City : GREENWOOD
State : DE
Zip : 19950-4682
Country : US
Telephone Number : 302-232-3330
Fax Number :
Provider Business Practice Location Address
First Line : 14712 WOODBRIDGE RD
Second Line :
City : GREENWOOD
State : DE
Zip : 19950-4682
Country : US
Telephone Number : 302-232-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2016
Last Update Date : 12/04/2016

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Directions to “ CARMEN CHONA ATC” Practice Location

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