Provider Demographics
NPI:1609305812
Name:FREAD, CHELSEA (PT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:FREAD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:GLAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1319 E 45TH ST APT G2
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-4153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1319 E 45TH ST APT G2
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4153
Practice Address - Country:US
Practice Address - Phone:308-390-8566
Practice Address - Fax:308-398-5232
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3709225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist