Provider Demographics
NPI:1932478252
Name:CHAPPELL, GEOFFREY ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:GEOFFREY
Middle Name:ALAN
Last Name:CHAPPELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HIDDEN HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6000
Mailing Address - Country:US
Mailing Address - Phone:561-762-3628
Mailing Address - Fax:
Practice Address - Street 1:107 HIDDEN HOLLOW DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-6000
Practice Address - Country:US
Practice Address - Phone:561-762-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2314225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist