Provider Demographics
NPI:1821465048
Name:CHAFFIN, CARLY WARREN (DPT)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:WARREN
Last Name:CHAFFIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8059 MITCHELL LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-6821
Mailing Address - Country:US
Mailing Address - Phone:205-999-4622
Mailing Address - Fax:205-999-4622
Practice Address - Street 1:1860 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5062
Practice Address - Country:US
Practice Address - Phone:205-395-5003
Practice Address - Fax:205-395-5004
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist