Provider Demographics
NPI:1033511811
Name:HADLEY, CHANDA J (DPT)
Entity Type:Individual
Prefix:
First Name:CHANDA
Middle Name:J
Last Name:HADLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHANDA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 242278
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2278
Mailing Address - Country:US
Mailing Address - Phone:334-396-3273
Mailing Address - Fax:334-396-4905
Practice Address - Street 1:3827 JIMMY LEE SMITH PKWY
Practice Address - Street 2:SUITE 122
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2804
Practice Address - Country:US
Practice Address - Phone:770-943-1142
Practice Address - Fax:770-943-6021
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist