Healthcare Provider Details

I. General information

NPI: 1003383555
Provider Name (Legal Business Name): STEPHEN JOSEPH CHAPPELL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2018
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 PRINTERS PKWY
COLORADO SPRINGS CO
80910-6100
US

IV. Provider business mailing address

3690 CENTENNIAL BLVD
COLORADO SPRINGS CO
80907-4062
US

V. Phone/Fax

Practice location:
  • Phone: 719-635-8622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0015844
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: