Provider Demographics
NPI:1255326799
Name:CHILLE, DONALD KAYLOR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:KAYLOR
Last Name:CHILLE
Suffix:
Gender:M
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 1:300 E PLANK RD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4154
Mailing Address - Country:US
Mailing Address - Phone:814-941-7708
Mailing Address - Fax:814-941-7715
Practice Address - Street 1:3200 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4458
Practice Address - Country:US
Practice Address - Phone:814-944-9412
Practice Address - Fax:814-944-2503
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013520L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA913036OtherHIGHMARK
P14009Medicare UPIN
PA913036OtherHIGHMARK