Individual
CRYSTAL CHUDOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
702 3RD AVE, KINGSTON, PA 18704-5845
(570) 283-5848
Mailing address
64 BROOKSIDE ST, WILKES BARRE, PA 18705-2504
(570) 991-1945
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE009967
PA
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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