Provider Demographics
NPI:1093258337
Name:CONZETT, CHELSEA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:CONZETT
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 1:8073 WASHINGTON VILLAGE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1847
Mailing Address - Country:US
Mailing Address - Phone:937-813-8052
Mailing Address - Fax:937-813-8056
Practice Address - Street 1:6006 MAHONING AVE
Practice Address - Street 2:SUITE G
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2239
Practice Address - Country:US
Practice Address - Phone:330-755-3000
Practice Address - Fax:330-599-7008
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist