NPI 1003090309

Chad Davis, PTA

Practitioner Physical Therapy Assistant New Lenox, IL

Practice location

Address: 806 Laraway Rd #808, New Lenox, IL 60451-2694
Phone: (815) 462-8416
Fax: (815) 462-8425
Mailing address: 1521 Centurion Ln, New Lenox, IL 60451-2580

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X

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Registry record

NPI: 1003090309
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Dec 2007
Record last updated: 21 Dec 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.