Basic Information
| Provider Information | |||||||||
| NPI: | 1003422965 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCPHERSON | ||||||||
| FirstName: | CHANDLER | ||||||||
| MiddleName: | HAGAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 709 SMITH WAY | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421043018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2704277501 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 GIBSON BAY DR | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | KY | ||||||||
| PostalCode: | 404753800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8596265000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2020 | ||||||||
| LastUpdateDate: | 09/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 008076 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.