Provider Demographics
NPI:1891825881
Name:CHAPMAN, ELIZABETH MISCALLY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MISCALLY
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:DOROTHY
Other - Middle Name:MISCALLY
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:1104 BEVILLE ROAD
Mailing Address - Street 2:SUITE J
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114
Mailing Address - Country:US
Mailing Address - Phone:386-252-7837
Mailing Address - Fax:385-252-0021
Practice Address - Street 1:1104 BEVILLE ROAD
Practice Address - Street 2:SUITE J
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114
Practice Address - Country:US
Practice Address - Phone:386-252-7837
Practice Address - Fax:385-252-0021
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20022251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY097MOtherBCBS