Provider Demographics
NPI:1497466502
Name:NORRIS, CHELSEA MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WEST ALEXANDRIA
Mailing Address - State:OH
Mailing Address - Zip Code:45381-9306
Mailing Address - Country:US
Mailing Address - Phone:937-727-8035
Mailing Address - Fax:
Practice Address - Street 1:55 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:WEST ALEXANDRIA
Practice Address - State:OH
Practice Address - Zip Code:45381-9306
Practice Address - Country:US
Practice Address - Phone:269-806-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.025065225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH33.025065OtherMASSAGE THERAPY LICENSE