Individual
CHADDRICK POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, OTA
Contact information
Practice address
4261 E UNIVERSITY DR STE 30-165, PROSPER, TX 75078
(972) 347-9604
(972) 499-2527
Mailing address
4261 E UNIVERSITY DR STE 30-165, PROSPER, TX 75078-9152
(972) 347-9454
(972) 499-2527
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
213531
TX
225100000X
Physical Therapist
Primary
1309289
TX
Other
Enumeration date
10/04/2015
Last updated
01/10/2025
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