Individual
MRS. ALEXIS R CHANTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
876A E MAIN ST, BEDFORD, VA 24523-2904
(434) 947-5321
(434) 947-5324
Mailing address
8243 CHARLEMONT RD, GOODE, VA 24556-3112
(814) 574-1582
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002287
VA
363AM0700X
Medical Physician Assistant
0110002287
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
541667390
TAX ID
VA
Enumeration date
05/22/2006
Last updated
01/31/2022
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