Provider Demographics
NPI:1619242203
Name:MCKENZIE, ANNA CHELSIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CHELSIE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:CHELSIE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4031 BETHEL RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640
Mailing Address - Country:US
Mailing Address - Phone:740-418-2686
Mailing Address - Fax:
Practice Address - Street 1:11268 COUNTY ROAD 550
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9789
Practice Address - Country:US
Practice Address - Phone:740-773-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA. 07589163WR0400X
OHPT0168672251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation