Provider Demographics
NPI:1659444156
Name:SAELIM, CHANCE CHETTA (PT)
Entity type:Individual
Prefix:
First Name:CHANCE
Middle Name:CHETTA
Last Name:SAELIM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1301 SE LYNN LANE
Mailing Address - Street 2:CHANCE PHYSICAL THERAPY & FITNESS PC
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-6845
Mailing Address - Country:US
Mailing Address - Phone:580-286-7848
Mailing Address - Fax:580-286-7863
Practice Address - Street 1:1301 SE LYNN LANE
Practice Address - Street 2:CHANCE PHYSICAL THERAPY & FITNESS PC
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-6845
Practice Address - Country:US
Practice Address - Phone:580-286-7848
Practice Address - Fax:580-286-7863
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist