Individual
SAMUEL COLE CHAFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
2801 S OLIVE ST, SUITE 9D, PINE BLUFF, AR 71603-5433
(870) 541-0003
(870) 541-0008
Mailing address
2801 S OLIVE ST, SUITE 9D, PINE BLUFF, AR 71603-5433
(870) 541-0003
(870) 541-0008
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1583
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130070721
—
AR
01
—
5T405
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/03/2007
Last updated
12/11/2012
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