Provider Demographics
NPI:1184040990
Name:CHAMBERS, RICHARD EDWARD II (DPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EDWARD
Last Name:CHAMBERS
Suffix:II
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 1:4796 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8034
Mailing Address - Country:US
Mailing Address - Phone:850-529-8093
Mailing Address - Fax:
Practice Address - Street 1:2065 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5931
Practice Address - Country:US
Practice Address - Phone:850-477-6966
Practice Address - Fax:850-477-0267
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 29283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist