Provider Demographics
NPI:1114137692
Name:HAMMONDS CHAVIS, DEBBIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:
Last Name:HAMMONDS CHAVIS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WEST THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28364
Mailing Address - Country:US
Mailing Address - Phone:910-522-1016
Mailing Address - Fax:910-521-4722
Practice Address - Street 1:209 WEST THIRD STREET
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28364
Practice Address - Country:US
Practice Address - Phone:910-522-1016
Practice Address - Fax:910-521-4722
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211900Medicaid
NC7211900Medicaid