Individual
BRENDA CHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1415
WY
225100000X
Physical Therapist
Primary
PT001890
GA
225100000X
Physical Therapist
PTP-PT-LIC 3577
MT
Other
Enumeration date
05/11/2012
Last updated
02/02/2024
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