Provider Demographics
NPI:1649682634
Name:COIL, CHAUCEY (DPT)
Entity type:Individual
Prefix:
First Name:CHAUCEY
Middle Name:
Last Name:COIL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16737 DARLING RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46797-9760
Mailing Address - Country:US
Mailing Address - Phone:260-557-4350
Mailing Address - Fax:
Practice Address - Street 1:4111 PARK PLACE DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-6002
Practice Address - Country:US
Practice Address - Phone:260-373-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010589A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist