Basic Information
| Provider Information | |||||||||
| NPI: | 1861156556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENDERSON | ||||||||
| FirstName: | CHELSEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4394 KC 370 | ||||||||
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| City: | MENARD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 768595554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103098279 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3155 AVENUE C | ||||||||
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| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591028109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066568818 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2021 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1348721 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.