MEDICARE: MELANIE KATHLEEN CHANDLER MPT

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	1140184	TX

General Provider Information

NPI Number	:	1215156641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE KATHLEEN CHANDLER MPT

Provider Business Mailing Address
First Line	:	54 RAINEY ST
Second Line	:	#503
City	:	AUSTIN
State	:	TX
Zip	:	78701-4311
Country	:	US
Telephone Number	:	817-714-8895
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 SLAUGHTER LN W
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-5706
Country	:	US
Telephone Number	:	512-282-0141
Fax Number	:

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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