Provider Demographics
NPI:1417622994
Name:DES ROSIERS, CHELSEA LAUREN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LAUREN
Last Name:DES ROSIERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 BROOKPARK RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44129-1218
Mailing Address - Country:US
Mailing Address - Phone:216-351-6270
Mailing Address - Fax:216-351-6130
Practice Address - Street 1:6204 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44129-1218
Practice Address - Country:US
Practice Address - Phone:216-351-6270
Practice Address - Fax:216-351-6130
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6983152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist