Doctor Name: | KELLY DEANN CHANCE |
NPI Number: | 1144556325 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | 1150565 |
Business Practice Address: | 2519 S Lakeline Blvd, Suite 100 Tillman Physical Therapy & Sports Training Center, Inc Cedar Park, TX - 786132964 |
Business Phone Number: | 5123316200 |
Business Fax Number: | 5123314312 |
Mailing Address: | 2519 S Lakeline Blvd, Suite 100, Tillman Physical Therapy & Sports Training Center, Inc CEDAR PARK |
State: | TX |
Postal Code: | 786132964 |
Phone Number: | 5123316200 |
Fax Number: | 5123314312 |
NPI Enumeration Date: | 10/23/2009 |
NPI Last Update Date: | 10/23/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1150565 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |