Provider Demographics
NPI:1982647145
Name:CHADWELL, DANIEL LOUIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LOUIS
Last Name:CHADWELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 W 13400 S
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-5819
Mailing Address - Country:US
Mailing Address - Phone:801-738-2065
Mailing Address - Fax:
Practice Address - Street 1:3741 W 12600 S
Practice Address - Street 2:INTERMOUNTAIN RIVERTON HOSPITAL
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7215
Practice Address - Country:US
Practice Address - Phone:801-285-4633
Practice Address - Fax:402-943-5539
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8471398-4104231H00000X
UT8471398-4101237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT8471398-4101OtherSTATE OF UTAH LICENSE
NE186OtherLICENSE