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General NPI Number Information
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NPI Number | 1467419879
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Entity Type | Individual
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Provider Name | CHANEY STILIGCH MOTTIN MAED, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 6100 OLEANDER DR ATTN: CMOTTIN
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City | ORLANDO
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State | FL
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Zip | 32807
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Country | US
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Telephone | 407-482-6300
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Fax | 407-482-6325
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Provider Business Mailing Address
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Address Line | 2425 E JERSEY AVE
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City | ORLANDO
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State | FL
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Zip | 32806-5022
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Country | US
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Telephone | 407-376-3061
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | AL1545
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License Number State | FL
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