MEDICARE: MR. DAVID A CHAPLA 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
1	225X00000X	Occupational Therapist	OT0414	NV

General Provider Information

NPI Number	:	1083800866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID A CHAPLA OTR

Provider Business Mailing Address
First Line	:	2035 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2223
Country	:	US
Telephone Number	:	702-386-7980
Fax Number	:

Provider Business Practice Location Address
First Line	:	4560 SE INTERNATIONAL WAY
Second Line	:	SUITE 100 CONSONUS HEALTHCARE SERVICES
City	:	MILWAUKIE
State	:	OR
Zip	:	97222
Country	:	US
Telephone Number	:	971-206-5149
Fax Number	:	971-206-5209

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

Provider Enumeration Date	:	09/14/2007
Last Update Date	:	01/16/2015

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