Individual
MS. JENNIFER H CHANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
639 W COULTER AVE, POWELL, WY 82435
(307) 754-9262
Mailing address
185 EVERGREEN DR, BOISE, ID 83716-3023
(208) 891-1440
(208) 442-2358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
01608
MO
225100000X
Physical Therapist
Primary
1779
WY
225100000X
Physical Therapist
PT - 2032
ID
Other
Enumeration date
12/23/2005
Last updated
10/12/2018
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