Provider Demographics
NPI:1164572376
Name:CHIPMAN, ERIC JAMES (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:CHIPMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 GARFIELD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-2057
Mailing Address - Country:US
Mailing Address - Phone:712-755-4342
Mailing Address - Fax:712-755-4513
Practice Address - Street 1:1213 GARFIELD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-2057
Practice Address - Country:US
Practice Address - Phone:712-755-4342
Practice Address - Fax:712-755-4513
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI19421Medicare ID - Type Unspecified