Healthcare Provider Details

I. General information

NPI: 1689130239
Provider Name (Legal Business Name): GABRIELLE GRACE CHANEY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2019
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 W HORIZON RIDGE PKWY STE 140
HENDERSON NV
89052-4445
US

IV. Provider business mailing address

3041 W HORIZON RIDGE PKWY STE 140
HENDERSON NV
89052-4445
US

V. Phone/Fax

Practice location:
  • Phone: 702-565-6565
  • Fax: 702-565-8898
Mailing address:
  • Phone: 702-565-6565
  • Fax: 702-565-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6847
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT0506827
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: