Provider Demographics
NPI:1083085120
Name:LYNN, CHELSEA RENEA (PT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:RENEA
Last Name:LYNN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:R
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:20 OVERBROOK DR STE D
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1147
Mailing Address - Country:US
Mailing Address - Phone:513-539-2886
Mailing Address - Fax:877-430-7975
Practice Address - Street 1:20 OVERBROOK DR STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1147
Practice Address - Country:US
Practice Address - Phone:513-539-2886
Practice Address - Fax:877-430-7975
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 015294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist