Provider Demographics
NPI:1316214497
Name:CHEVALIER, DONALD A (LMT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:A
Last Name:CHEVALIER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-0532
Mailing Address - Country:US
Mailing Address - Phone:860-306-3590
Mailing Address - Fax:
Practice Address - Street 1:35 COLD SPRING RD
Practice Address - Street 2:SUITE 124
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3160
Practice Address - Country:US
Practice Address - Phone:860-306-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6016225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist