Provider Demographics
NPI:1770322836
Name:MCKENZIE, CHLOE MICHELLE SEFEROS (DPT)
Entity type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:MICHELLE SEFEROS
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4648 MONTICELLO PL
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-8685
Mailing Address - Country:US
Mailing Address - Phone:360-204-8716
Mailing Address - Fax:
Practice Address - Street 1:108 N 2ND ST APT A
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2590
Practice Address - Country:US
Practice Address - Phone:406-201-5461
Practice Address - Fax:406-215-9002
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-29783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist