Provider Demographics
NPI:1275196289
Name:KUFAHL, CHELSEA RAE (DPT)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:RAE
Last Name:KUFAHL
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 1:610 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:KS
Mailing Address - Zip Code:66521-3819
Mailing Address - Country:US
Mailing Address - Phone:785-556-0405
Mailing Address - Fax:
Practice Address - Street 1:100 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ONAGA
Practice Address - State:KS
Practice Address - Zip Code:66521-9574
Practice Address - Country:US
Practice Address - Phone:785-889-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist