Organization Name: | PELHAM B. CHASTANG |
NPI Number: | 1023184587 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTYE HALL CHASTANG (PHYSICAL THERAPIST) |
Mailing Address: | 39821 Duffee Ln Bay Minette |
State: | AL US |
Postal Code: | 365076877 |
Phone Number: | 2519377600 |
Fax Number: | 2519377653 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | PTH2770 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |