Chad Alva Powell, DPT

Individual provider Active NPI Physical Therapist · Hermann, MO

NPI 1972851632 · NPPES record last updated Aug 28, 2012

Key facts

NPI
1972851632
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2012027761 (MO)
Practice address
2064 Village LN
Hermann, MO 65041-1592
Phone
(573) 486-1600
Fax
(573) 486-1605
NPI assigned
Aug 28, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2012027761MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Outreach, L.L.C. Past Accepting new patients
Rehab Outreach, L.L.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2012027761 MO Yes

Addresses

Primary practice location

2064 Village LN
Hermann, MO 65041-1592

Mailing address

310 Miller St
Montgomery City, MO 63361-2008
Phone (573) 253-1633

Other providers in Hermann, MO

All providers in Hermann, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.