MEDICARE: CHANIN TONG

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
1	225100000X	Physical Therapist	1170881	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861514762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANIN TONG

Provider Business Mailing Address
First Line	:	1211 XENIA AVE
Second Line	:
City	:	YELLOW SPRINGS
State	:	OH
Zip	:	45387-1105
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 XENIA AVE
Second Line	:
City	:	YELLOW SPRINGS
State	:	OH
Zip	:	45387-1105
Country	:	US
Telephone Number	:	415-377-1171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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Directions to “ CHANIN TONG ” Practice Location

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