Provider Demographics
NPI:1003529710
Name:CHANDLER, OCTASIA (BS)
Entity Type:Individual
Prefix:
First Name:OCTASIA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 HIGHWAY 463 N
Mailing Address - Street 2:
Mailing Address - City:TRUMANN
Mailing Address - State:AR
Mailing Address - Zip Code:72472-1636
Mailing Address - Country:US
Mailing Address - Phone:870-418-0794
Mailing Address - Fax:
Practice Address - Street 1:831 HIGHWAY 463 N
Practice Address - Street 2:
Practice Address - City:TRUMANN
Practice Address - State:AR
Practice Address - Zip Code:72472-1636
Practice Address - Country:US
Practice Address - Phone:870-418-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist