Provider Demographics
NPI:1447088216
Name:IMUA PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:IMUA PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:CHIH YUEH
Authorized Official - Last Name:CORNWELL-CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:510-449-8273
Mailing Address - Street 1:7404 JUNE BUG LN
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9311
Mailing Address - Country:US
Mailing Address - Phone:510-449-8273
Mailing Address - Fax:
Practice Address - Street 1:7404 JUNE BUG LN
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-9311
Practice Address - Country:US
Practice Address - Phone:510-449-8273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty