Provider Demographics
NPI:1437446937
Name:CHENAULT, VERONICA J (PT, DPT, CKTP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:J
Last Name:CHENAULT
Suffix:
Gender:F
Credentials:PT, DPT, CKTP
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 323
Mailing Address - Street 2:
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836-0323
Mailing Address - Country:US
Mailing Address - Phone:517-223-8308
Mailing Address - Fax:517-223-8344
Practice Address - Street 1:7701 GRAND RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9396
Practice Address - Country:US
Practice Address - Phone:517-579-2839
Practice Address - Fax:517-579-2838
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist