Basic Information
| Provider Information | |||||||||
| NPI: | 1578913604 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VIRANT | ||||||||
| FirstName: | CHELSEA | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29125 BUCKINGHAM ST | ||||||||
| Address2: | |||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481544480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485654000 | ||||||||
| FaxNumber: | 2485654030 | ||||||||
| Practice Location | |||||||||
| Address1: | 26850 PROVIDENCE PKWY STE 365 | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483741262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483803550 | ||||||||
| FaxNumber: | 2483801620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2016 | ||||||||
| LastUpdateDate: | 11/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501017706 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.