Provider Demographics
NPI:1285463893
Name:GALBRETH, CHAD NELSON
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:NELSON
Last Name:GALBRETH
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 1:11359 GALLATIN TRL
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2388
Mailing Address - Country:US
Mailing Address - Phone:941-587-0717
Mailing Address - Fax:
Practice Address - Street 1:11359 GALLATIN TRL
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2388
Practice Address - Country:US
Practice Address - Phone:941-587-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA29135225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant