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General NPI Number Information
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NPI Number | 1265113021
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Entity Type | Individual
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Provider Name | LISA MICHELE CHATFIELD LMT
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Gender | Female
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 20 TOWN SQ
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City | GREENWOOD
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State | AR
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Zip | 72936-3200
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Country | US
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Telephone | 479-366-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 9505 CHAD COLLEY BLVD APT 1303
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City | FORT SMITH
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State | AR
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Zip | 72916-5802
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Country | US
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Telephone | 479-366-0034
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 9330
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License Number State | AR
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