Provider Demographics
NPI:1356656797
Name:NOEL, CHELSEA MANCHESTER (PT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MANCHESTER
Last Name:NOEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-3920
Mailing Address - Country:US
Mailing Address - Phone:401-474-3734
Mailing Address - Fax:401-624-6561
Practice Address - Street 1:2633 MAIN RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-3920
Practice Address - Country:US
Practice Address - Phone:401-474-3734
Practice Address - Fax:401-624-6561
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI02274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist