Provider Demographics
NPI:1982892899
Name:CHANDLER, BARBARA A (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:CHANDLER
Suffix:
Gender:F
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:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:FOURMILE
Mailing Address - State:KY
Mailing Address - Zip Code:40939-0192
Mailing Address - Country:US
Mailing Address - Phone:606-658-9654
Mailing Address - Fax:
Practice Address - Street 1:166 SIZEMORE LANE
Practice Address - Street 2:
Practice Address - City:FLAT LICK
Practice Address - State:KY
Practice Address - Zip Code:40935
Practice Address - Country:US
Practice Address - Phone:606-658-9654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4433225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87009981Medicaid
KY5018601Medicare PIN