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Individual
NANCY SUSAN CHENNELL
Active
Individual
NANCY SUSAN CHENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00008672
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT0086272
PT LIS
CA
Enumeration date
04/04/2007
Last updated
10/06/2008
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