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General NPI Number Information
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NPI Number | 1164961579
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Entity Type | Organization
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Legal Business Name | CHELSEA PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 14650 E OLD US 12 SUITE 101
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City | CHELSEA
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State | MI
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Zip | 48118-1383
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Country | US
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Telephone | 734-593-5979
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Fax |
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Provider Business Mailing Address
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Address Line | 775 S MAIN ST
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City | CHELSEA
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State | MI
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Zip | 48118-1383
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Country | US
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Telephone | 734-563-4073
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Fax | 734-475-6819
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MRS. NANCY GRAEBNER
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Credential |
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Telephone | 734-593-5361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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