Healthcare Provider Details

I. General information

NPI: 1194009738
Provider Name (Legal Business Name): CHELSEA M HOVIS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 E SOUTHERN AVE
TEMPE AZ
85282-7518
US

IV. Provider business mailing address

1930 E SOUTHERN AVE
TEMPE AZ
85282-7518
US

V. Phone/Fax

Practice location:
  • Phone: 480-456-0719
  • Fax:
Mailing address:
  • Phone: 480-456-0719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9518
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: