Healthcare Provider Details

I. General information

NPI: 1346165735
Provider Name (Legal Business Name): CHELSEA VICTORIA RIDDLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 HIGH TOP DR
CANTON NC
28716-5361
US

IV. Provider business mailing address

156 HIGH TOP DR
CANTON NC
28716-5361
US

V. Phone/Fax

Practice location:
  • Phone: 828-508-2952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: