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General NPI Number Information
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NPI Number | 1861129215
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Entity Type | Individual
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Provider Name | CHANDLER JAMES SHILEY PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 5787 VINELAND RD STE 104
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City | ORLANDO
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State | FL
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Zip | 32819-7806
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Country | US
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Telephone | 407-354-3906
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Fax | 407-354-3907
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Provider Business Mailing Address
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Address Line | 622 ARBOR POINTE AVE
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City | MINNEOLA
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State | FL
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Zip | 34715-6048
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Country | US
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Telephone | 352-272-6193
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 38691
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License Number State | FL
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