Individual
MR. STEPHEN CHASTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
3708 NORTHSIDE DRIVE, MACON, GA 31210
(478) 254-5301
(478) 254-5463
Mailing address
3708 NORTHSIDE DRIVE, MACON, GA 31210
(478) 254-5301
(478) 254-5463
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001785
GA
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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