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General NPI Number Information
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NPI Number | 1194849075
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Entity Type | Individual
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Provider Name | GLENDA C. CHAVEZ P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/18/2007
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 529 E ST
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City | BRAWLEY
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State | CA
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Zip | 92227-1930
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Country | US
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Telephone | 760-344-9000
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Fax | 760-344-9191
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Provider Business Mailing Address
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Address Line | 428 N IMPERIAL AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-2329
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Country | US
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Telephone | 760-353-3422
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Fax | 760-353-9163
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT32601
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License Number State | CA
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