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NPI Code Detail

MEDICARE: CHAD JEFFREY TENNEY PT

MEDICARE: CHAD JEFFREY TENNEY 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
1225100000XPhysical Therapist4088OR
2225100000XPhysical Therapist6109493-2401UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215910161
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD JEFFREY TENNEY PT
Provider Business Mailing Address
First Line : 5253 S 6150 W
Second Line :
City : HOOPER
State : UT
Zip : 84315-6702
Country : US
Telephone Number : 801-985-1878
Fax Number : 801-689-0201
Provider Business Practice Location Address
First Line : 3476 W 4600 S
Second Line :
City : WEST HAVEN
State : UT
Zip : 84401-9203
Country : US
Telephone Number : 801-689-0200
Fax Number : 801-689-0201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 04/02/2018

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