Provider Demographics
NPI:1558840157
Name:DEWEES, CHELSEA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:DEWEES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 CELEBRITY DR
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-3875
Mailing Address - Country:US
Mailing Address - Phone:318-224-8994
Mailing Address - Fax:
Practice Address - Street 1:900 PERSHING HWY
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-2046
Practice Address - Country:US
Practice Address - Phone:318-259-9899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09661225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist