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NPI Code Detail

MEDICARE: ANNA CHANCEY OTR

MEDICARE: ANNA CHANCEY OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist7041TN
2225XP0200XPediatric Occupational Therapist7041TN

General Provider Information

NPI Number : 1063171890
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA CHANCEY OTR
Provider Business Mailing Address
First Line : PO BOX 2378
Second Line :
City : DALTON
State : GA
Zip : 30722-2378
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2276 CANDIES LN NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-2619
Country : US
Telephone Number : 423-328-8745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2021
Last Update Date : 12/10/2021

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Directions to “ ANNA CHANCEY OTR” Practice Location

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