Healthcare Provider Details

I. General information

NPI: 1255027710
Provider Name (Legal Business Name): DR. CHANCE LEE CAUBLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6439 GARNERS FERRY RD
COLUMBIA SC
29209-1638
US

IV. Provider business mailing address

255 YATES RD
SALISBURY NC
28146-2309
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-4000
  • Fax:
Mailing address:
  • Phone: 980-234-7383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: