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NPI Code Detail

MEDICARE: GABRIELLE GRACE CHANEY PT, DPT

MEDICARE: GABRIELLE GRACE CHANEY PT, DPT
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
12255A2300XAthletic TrainerAT0506827NV
2225100000XPhysical Therapist6847NV

General Provider Information

NPI Number : 1689130239
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELLE GRACE CHANEY PT, DPT
Provider Business Mailing Address
First Line : 3041 W HORIZON RIDGE PKWY STE 140
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4445
Country : US
Telephone Number : 702-565-6565
Fax Number : 702-565-8898
Provider Business Practice Location Address
First Line : 3041 W HORIZON RIDGE PKWY STE 140
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4445
Country : US
Telephone Number : 702-565-6565
Fax Number : 702-565-8898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2019
Last Update Date : 01/21/2026

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