Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chan Jin Park

Individual provider Physical Therapy Assistant · NPI 1649006883

Chan Jin Park is a Physical Therapy Assistant in Toledo, Ohio. Practices as a sole proprietor. Licensed in Michigan and Ohio.

Licensed in
MI, OH
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

1604 Roosevelt Ave
Toledo, OH 43607-1461
Phone: (419) 340-6188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA013736 (OH)
Physical Therapy Assistant Taxonomy 225200000X · Licence 5502008435 (MI)

Record details

NPI number1649006883
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 13, 2024
Last updated in NPPESSeptember 13, 2024
Certification dateSeptember 12, 2024
Mailing address1604 Roosevelt Ave, Toledo, OH 43607-1461

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