Provider Demographics
NPI:1669281531
Name:FOLTZ, CHANTEL LENAE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:LENAE
Last Name:FOLTZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 HORSE THIEF LN
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-3102
Mailing Address - Country:US
Mailing Address - Phone:970-903-1722
Mailing Address - Fax:
Practice Address - Street 1:311 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-2401
Practice Address - Country:US
Practice Address - Phone:920-743-0255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17040-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist