Provider Demographics
NPI:1306146071
Name:HANDLEY, CHAD (RPH)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:HANDLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 S RESERVE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7322
Mailing Address - Country:US
Mailing Address - Phone:406-251-5415
Mailing Address - Fax:406-251-8663
Practice Address - Street 1:3801 S RESERVE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7322
Practice Address - Country:US
Practice Address - Phone:406-251-5415
Practice Address - Fax:406-251-8663
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist