Provider Demographics
NPI:1710595806
Name:CHADDERDON, JOYCE LYNN (PT, DPT, NCS)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:LYNN
Last Name:CHADDERDON
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:LYNN
Other - Last Name:FABISIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2312 S 6TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-4340
Mailing Address - Country:US
Mailing Address - Phone:541-236-2123
Mailing Address - Fax:888-706-1637
Practice Address - Street 1:2312 S 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-4340
Practice Address - Country:US
Practice Address - Phone:541-236-2123
Practice Address - Fax:888-706-1637
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist