Provider Demographics
NPI:1154938074
Name:CHAMBERS, DAN
Entity type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 MOUNTAIN RD UNIT 8
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-6945
Mailing Address - Country:US
Mailing Address - Phone:781-752-5149
Mailing Address - Fax:
Practice Address - Street 1:179 MOUNTAIN RD UNIT 8
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6945
Practice Address - Country:US
Practice Address - Phone:781-752-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant