Provider Demographics
NPI:1437551769
Name:ROTHROCK, CHELSEA (PA-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:ROTHROCK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-2129
Mailing Address - Country:US
Mailing Address - Phone:717-437-9000
Mailing Address - Fax:717-437-9001
Practice Address - Street 1:134 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2129
Practice Address - Country:US
Practice Address - Phone:717-437-9000
Practice Address - Fax:717-437-9001
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056989363A00000X
PAOA003343363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant