Healthcare Provider Details

I. General information

NPI: 1770101388
Provider Name (Legal Business Name): CHELSEA CLARK JANASEK PT, DPT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BEN CASEY DR STE 127
FORT MILL SC
29708-8557
US

IV. Provider business mailing address

10 TUPELO CT
GREENVILLE SC
29609-6027
US

V. Phone/Fax

Practice location:
  • Phone: 803-802-5855
  • Fax:
Mailing address:
  • Phone: 804-516-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number10410
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: