Provider Demographics
NPI:1346874690
Name:MACHAL, CHANADIE CHARLENE
Entity Type:Individual
Prefix:
First Name:CHANADIE
Middle Name:CHARLENE
Last Name:MACHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:CRITTENDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41030-8425
Mailing Address - Country:US
Mailing Address - Phone:859-704-0886
Mailing Address - Fax:
Practice Address - Street 1:1180 ROGERS RD
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-8425
Practice Address - Country:US
Practice Address - Phone:859-704-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty