Provider Demographics
NPI:1548533979
Name:DALRYMPLE, CHERYL JOHIAN (PTA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:JOHIAN
Last Name:DALRYMPLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:JOHIAN
Other - Last Name:DALRYMPLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:9512 DANIELVILLE DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-5329
Mailing Address - Country:US
Mailing Address - Phone:540-972-7022
Mailing Address - Fax:
Practice Address - Street 1:600 S BROAD ST
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3346
Practice Address - Country:US
Practice Address - Phone:610-925-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306601556225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant