Provider Demographics
NPI:1285381038
Name:LADD, CHASE (MS, ATC/L)
Entity type:Individual
Prefix:
First Name:CHASE
Middle Name:
Last Name:LADD
Suffix:
Gender:M
Credentials:MS, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4473 CANTERBURY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:AL
Mailing Address - Zip Code:35117-3119
Mailing Address - Country:US
Mailing Address - Phone:601-218-5276
Mailing Address - Fax:
Practice Address - Street 1:200 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1842
Practice Address - Country:US
Practice Address - Phone:601-218-5276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer