Provider Demographics
NPI:1770242919
Name:DAVIS, CHASE (PTA)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 DELPHINIUM DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3256
Mailing Address - Country:US
Mailing Address - Phone:320-262-9562
Mailing Address - Fax:
Practice Address - Street 1:474 HIGHWAY 282
Practice Address - Street 2:
Practice Address - City:CLANCY
Practice Address - State:MT
Practice Address - Zip Code:59634-9519
Practice Address - Country:US
Practice Address - Phone:406-640-4958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant