MEDICARE: CHELSEY LEIGH CLAASSEN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2016024352	MO
2	225100000X	Physical Therapist	11-05408	KS
3	225100000X	Physical Therapist	294538	CA

General Provider Information

NPI Number	:	1801246848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY LEIGH CLAASSEN PT, DPT

Provider Business Mailing Address
First Line	:	4205 SAN FELIPE RD STE 100
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135-1546
Country	:	US
Telephone Number	:	408-238-1552
Fax Number	:	408-841-7205

Provider Business Practice Location Address
First Line	:	4205 SAN FELIPE RD STE 100
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95135-1546
Country	:	US
Telephone Number	:	408-238-1552
Fax Number	:	408-841-7205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	04/02/2024

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