MEDICARE: MICHAEL CHAFFEE PT

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
1	225100000X	Physical Therapist	PT7719	OH

General Provider Information

NPI Number	:	1063462505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHAFFEE PT

Provider Business Mailing Address
First Line	:	PO BOX 392573
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1098 N ELLSWORTH AVE
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-1536
Country	:	US
Telephone Number	:	234-567-4687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	10/08/2024

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