Provider Demographics
NPI:1629521166
Name:SICKEL, CHELSEA (DC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:SICKEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S ANGELL ST # 151
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5206
Mailing Address - Country:US
Mailing Address - Phone:617-431-6427
Mailing Address - Fax:
Practice Address - Street 1:250 WAMPANOAG TRAIL
Practice Address - Street 2:SUITE 306
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-5206
Practice Address - Country:US
Practice Address - Phone:401-223-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3559111N00000X
RIDC00446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty