Provider Demographics
NPI:1467570911
Name:WILLMANN-CHAFIN, CELESTE ANNETTE (LPTA)
Entity Type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:ANNETTE
Last Name:WILLMANN-CHAFIN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MISS
Other - First Name:CELESTE
Other - Middle Name:ANNETTE
Other - Last Name:WILLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:1503 E QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9274
Mailing Address - Country:US
Mailing Address - Phone:740-366-0860
Mailing Address - Fax:
Practice Address - Street 1:1640 WEST REDSTONE CENTER
Practice Address - Street 2:SUITE 200 SUPPLEMENTAL HEALTH CARE
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098
Practice Address - Country:US
Practice Address - Phone:513-791-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA02051225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant