Chaddrick Polk, PT, OTA
Physical Therapist in Prosper, TX. Individual provider (NPI-1).
NPI number1003286972
StatusActive
Last updated in NPPESJan 10, 2025
Details
- NPI
- 1003286972
- Entity type
- Individual (NPI-1)
- Name
- Chaddrick Polk
- Credential
- PT, OTA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 4, 2015
- Certification date
- Jan 10, 2025
- Last updated
- Jan 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 1309289 | TX | Yes |
| 224Z00000X | Occupational Therapy Assistant | 213531 | TX |
Practice location
4261 E University Dr Ste 30-165Prosper, TX 75078
Phone 972-347-9604 · Fax 972-499-2527
Mailing address
4261 E University Dr Ste 30-165Prosper, TX 75078-9152
Phone 972-347-9454 · Fax 972-499-2527
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