Individual
CONNIE CHEUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, MPH, RD/LD
Contact information
Practice address
1775 RIVERSIDE RD, ROSWELL, GA 30076-3314
(678) 557-0600
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(866) 370-8206
(517) 435-3670
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
LD002682
GA
225100000X
Physical Therapist
Primary
PT007815
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G708167
PTAN
GA
Enumeration date
05/28/2006
Last updated
12/10/2025
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