Provider Demographics
NPI:1073875803
Name:KING, CHELSEY M (DPT)
Entity Type:Individual
Prefix:MS
First Name:CHELSEY
Middle Name:M
Last Name:KING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3497 W 3500 S
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-2537
Mailing Address - Country:US
Mailing Address - Phone:208-403-4375
Mailing Address - Fax:801-987-8701
Practice Address - Street 1:3497 W 3500 S
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-2537
Practice Address - Country:US
Practice Address - Phone:208-403-4375
Practice Address - Fax:801-987-8701
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8217316-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist