Provider Demographics
NPI:1083282487
Name:FIELDS, CHANDLER THOMAS (DPT)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:THOMAS
Last Name:FIELDS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-921-6504
Practice Address - Street 1:815 OBERLIN RD STE 302
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1351
Practice Address - Country:US
Practice Address - Phone:919-670-4097
Practice Address - Fax:919-670-4098
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist