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General NPI Number Information
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NPI Number | 1114800893
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Entity Type | Individual
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Provider Name | CHANEY ALLEN
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Gender |
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 9818 US-62
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City | VIOLA
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State | AR
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Zip | 72583
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Country | US
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Telephone | 870-539-9969
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Fax |
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Provider Business Mailing Address
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Address Line | 95 CIRCLE DR
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City | EVENING SHADE
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State | AR
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Zip | 72532-9322
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5053
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License Number State | AR
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