Healthcare Provider Details

I. General information

NPI: 1598689143
Provider Name (Legal Business Name): CHANCE BEGAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25577 CONIFER RD UNIT 125
CONIFER CO
80433-9068
US

IV. Provider business mailing address

25 S 300 E UNIT 408
SALT LAKE CITY UT
84111-1609
US

V. Phone/Fax

Practice location:
  • Phone: 303-838-7444
  • Fax:
Mailing address:
  • Phone: 928-856-4803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0021520
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: