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Individual
TODD CHANCELLOR
Active
Individual
TODD CHANCELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12699
FL
310400000X
Assisted Living Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105771000
—
FL
Enumeration date
09/17/2018
Last updated
05/18/2020
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