Healthcare Provider Details

I. General information

NPI: 1508097510
Provider Name (Legal Business Name): CHELSEA LYNN SACKETT M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 S 3RD ST
YOUNGWOOD PA
15697-5100
US

IV. Provider business mailing address

403 S 3RD ST
YOUNGWOOD PA
15697-5100
US

V. Phone/Fax

Practice location:
  • Phone: 724-925-9220
  • Fax: 724-925-3742
Mailing address:
  • Phone: 724-925-9220
  • Fax: 724-925-3742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: