Provider Demographics
NPI:1891108262
Name:CREER, CHAYLA (DPT)
Entity Type:Individual
Prefix:DR
First Name:CHAYLA
Middle Name:
Last Name:CREER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CHAYLA
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5447 SHADY PINE ST S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-8543
Mailing Address - Country:US
Mailing Address - Phone:904-613-1195
Mailing Address - Fax:904-559-1688
Practice Address - Street 1:5447 SHADY PINE ST S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-8543
Practice Address - Country:US
Practice Address - Phone:318-272-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29037225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01363942OtherRR MEDICARE
FLHW684ZMedicare PIN