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General NPI Number Information
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NPI Number | 1265243497
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Entity Type | Individual
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Provider Name | CHELSEA EPPERSON ATC, OTC
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 1100 VIRGINIA AVE
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City | COLUMBIA
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State | MO
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Zip | 65212-0001
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Country | US
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Telephone | 573-882-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 2406 SPANISH BAY DR
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City | COLUMBIA
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State | MO
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Zip | 65202-3581
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Country | US
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Telephone | 573-619-4672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2011026851
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License Number State | MO
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