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Individual

CONNOR CHASTAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
2222 E HIGHLAND AVE STE 310, PHOENIX, AZ 85016-4879
(602) 512-8550
Mailing address
2222 E HIGHLAND AVE STE 310, PHOENIX, AZ 85016-4879
(602) 512-8550

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-32717
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016020804
PHYSICAL THERAPY LICENSE
MO
Enumeration date
05/25/2021
Last updated
12/02/2025
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