Individual
CHAD ALVA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2064 VILLAGE LN, HERMANN, MO 65041-1592
(573) 486-1600
(573) 486-1605
Mailing address
310 MILLER ST, MONTGOMERY CITY, MO 63361-2008
(573) 253-1633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2012027761
MO
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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