Provider Demographics
NPI:1558727693
Name:FREISTHLER, CHELSEA
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:FREISTHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:117 NORTH MILL ST
Mailing Address - City:BOTKINS
Mailing Address - State:OH
Mailing Address - Zip Code:45306-0292
Mailing Address - Country:US
Mailing Address - Phone:937-622-3779
Mailing Address - Fax:
Practice Address - Street 1:17296 WENGER RD
Practice Address - Street 2:
Practice Address - City:BOTKINS
Practice Address - State:OH
Practice Address - Zip Code:45306-9723
Practice Address - Country:US
Practice Address - Phone:937-622-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility