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General NPI Number Information
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NPI Number | 1134867468
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Entity Type | Individual
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Provider Name | ROBERT CHAFFEE ELAM
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Gender | Male
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 1406 WINTER DR
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City | LEBANON
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State | TN
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Zip | 37087-2530
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Country | US
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Telephone | 615-444-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 113 SILVER DOLLAR ST
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City | LASCASSAS
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State | TN
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Zip | 37085-4651
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Country | US
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Telephone | 901-800-7464
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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