Provider Demographics
NPI:1831640218
Name:MAHAFFEY, CHAD (LAT, MS, ATC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:MAHAFFEY
Suffix:
Gender:M
Credentials:LAT, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24416
Mailing Address - Country:US
Mailing Address - Phone:540-570-1884
Mailing Address - Fax:540-261-3890
Practice Address - Street 1:1 UNIVERSITY HILL DR
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:VA
Practice Address - Zip Code:24416-3038
Practice Address - Country:US
Practice Address - Phone:540-570-1884
Practice Address - Fax:540-261-3890
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260016402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer