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NPI Code Detail

MEDICARE: VERONICA J. CHENAULT PT, DPT, CKTP

MEDICARE: VERONICA J. CHENAULT PT, DPT, CKTP
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 Therapist5501014599MI

General Provider Information

NPI Number : 1437446937
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA J. CHENAULT PT, DPT, CKTP
Provider Business Mailing Address
First Line : PO BOX 323
Second Line :
City : FOWLERVILLE
State : MI
Zip : 48836-0323
Country : US
Telephone Number : 517-223-8308
Fax Number : 517-223-8344
Provider Business Practice Location Address
First Line : 7701 GRAND RIVER RD STE 100
Second Line :
City : BRIGHTON
State : MI
Zip : 48114-9396
Country : US
Telephone Number : 517-579-2839
Fax Number : 517-579-2838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2011
Last Update Date : 09/04/2020

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