Healthcare Provider Details

I. General information

NPI: 1447565114
Provider Name (Legal Business Name): CHELSEA LEIGH GELDMACHER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12509 VILLAGE CIRCLE DR
SAINT LOUIS MO
63127-1701
US

IV. Provider business mailing address

12509 VILLAGE CIRCLE DR
SAINT LOUIS MO
63127-1701
US

V. Phone/Fax

Practice location:
  • Phone: 314-270-7790
  • Fax: 314-849-2045
Mailing address:
  • Phone: 314-270-7790
  • Fax: 314-849-2045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2010022731
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: