MEDICARE: LACHELLE CHAPMAN 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
1	225100000X	Physical Therapist	4354	NM

General Provider Information

NPI Number	:	1780015826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LACHELLE CHAPMAN DPT

Provider Business Mailing Address
First Line	:	205 SPICER LAKE DR
Second Line	:
City	:	HOLLY RIDGE
State	:	NC
Zip	:	28445-8902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 SPICER LAKE DR
Second Line	:
City	:	HOLLY RIDGE
State	:	NC
Zip	:	28445-8902
Country	:	US
Telephone Number	:	949-722-7374
Fax Number	:

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

Provider Enumeration Date	:	11/27/2013
Last Update Date	:	05/03/2023

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