Provider Demographics
NPI:1376744466
Name:CHAMLEE, DAVID BOWER (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BOWER
Last Name:CHAMLEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29099 HOSPITAL RD.
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352
Mailing Address - Country:US
Mailing Address - Phone:909-337-0844
Mailing Address - Fax:909-337-0045
Practice Address - Street 1:29099 HOSPITAL RD.
Practice Address - Street 2:SUITE 106
Practice Address - City:LAKE ARROWHEAD
Practice Address - State:CA
Practice Address - Zip Code:92352
Practice Address - Country:US
Practice Address - Phone:909-337-0844
Practice Address - Fax:909-337-0045
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist