Provider Demographics
NPI:1144783697
Name:MONEY, CHANTEL MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:CHANTEL
Middle Name:MARIE
Last Name:MONEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49348-1109
Mailing Address - Country:US
Mailing Address - Phone:269-792-2249
Mailing Address - Fax:269-792-6121
Practice Address - Street 1:425 E ELM ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1109
Practice Address - Country:US
Practice Address - Phone:269-792-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004176225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant