Chung, Tina

Chung, Tina is an individual health care provider with primary practice located at 2100 W Main St , Russellville AR 72801-2758. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Chung, Tina can be contacted via phone (479) 968-2525.

Contact Information

Primary practice address
2100 W Main St Russellville AR 72801-2758
Phone: (479) 968-2525
Fax: (479) 968-2538
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X O-T0958 Arkansas

Profile Details

NPI number 1942433149
LBN Legal business name Chung, Tina
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2009
Last updated Feb 24th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942433149 NPPES
Arkansas MEDICAID 180268721

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