Provider Demographics
NPI:1902059587
Name:CHESLA, LORA KATHLEEN (PTA)
Entity Type:Individual
Prefix:MISS
First Name:LORA
Middle Name:KATHLEEN
Last Name:CHESLA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:LORA
Other - Middle Name:KATHLEEN
Other - Last Name:EWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6365 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:STEWARTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17363-7672
Mailing Address - Country:US
Mailing Address - Phone:717-993-2242
Mailing Address - Fax:
Practice Address - Street 1:3377 FOX RUN RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-3705
Practice Address - Country:US
Practice Address - Phone:717-767-5634
Practice Address - Fax:717-767-5657
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000868225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant