MEDICARE: CHAMBERS INTEGRATED HEALTH PLLC

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		AZ

General Provider Information

NPI Number	:	1275863474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMBERS INTEGRATED HEALTH PLLC

Provider Business Mailing Address
First Line	:	4925 W BELL RD STE C7
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3431
Country	:	US
Telephone Number	:	602-789-6753
Fax Number	:	602-789-6755

Provider Business Practice Location Address
First Line	:	4925 W BELL RD STE C7
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-3431
Country	:	US
Telephone Number	:	602-789-6753
Fax Number	:	602-789-6755

Authorized Official
Title or Position	:	OWNER
Name	:	TODD CHAMBERS
Credential	:
Telephone Number	:	602-789-6753

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	01/11/2010

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