MEDICARE: KIMBERLY CHAPLOW 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
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05569	OTHER	OH	LICENSE #

General Provider Information

NPI Number	:	1750498614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY CHAPLOW PT

Provider Business Mailing Address
First Line	:	6006 MAHONING AVE
Second Line	:	STE G
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515-2239
Country	:	US
Telephone Number	:	330-755-3000
Fax Number	:	330-599-7008

Provider Business Practice Location Address
First Line	:	6006 MAHONING AVE
Second Line	:	STE G
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515-2239
Country	:	US
Telephone Number	:	330-755-3000
Fax Number	:	330-599-7008

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	04/27/2011

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Directions to “ KIMBERLY CHAPLOW PT” Practice Location

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