Individual
KENTON CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
1700 MARLANDWOOD RD, TEMPLE, TX 76502-2842
(254) 743-6200
Mailing address
1700 MARLANDWOOD RD, TEMPLE, TX 76502-2842
(254) 743-6200
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208710
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208710
OTA
TX
Enumeration date
08/31/2018
Last updated
08/31/2018
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