Healthcare Provider Details

I. General information

NPI: 1588994743
Provider Name (Legal Business Name): CHELSEA ELIZABETH SEWELL MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 DARBY CREEK RD. SUITE16
LEXINGTON KY
40509
US

IV. Provider business mailing address

334 S FORK TERRACE RD
GLASGOW KY
42141-7024
US

V. Phone/Fax

Practice location:
  • Phone: 859-543-9463
  • Fax:
Mailing address:
  • Phone: 270-404-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number005299
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number005299
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: