Most Relevant Information
Provider Data
| NPI Number: | 1003286972 |
| Provider Name: | CHADDRICK POLK PT, OTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 1309289 |
Most Important Dates
| Enumeration Date: | 10/04/2015 |
| Last Updated: | 12/30/2022 |
Provider Practice Location
4261 E UNIVERSITY DR STE 30-165
PROSPER
TX
75078
Practice Location Phone/Fax
| Phone: | 9723479604 |
| Fax: | 9724992527 |
Provider Mailing Location
4261 E UNIVERSITY DR STE 30-165
PROSPER
TX
750789152
Provider Mailing Phone/Fax
| Phone: | 9723479454 |
| Fax: | 9724992527 |