Provider Demographics
NPI:1669812533
Name:FREY, CHELSEA FAITH (OD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:FAITH
Last Name:FREY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:FAITH
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1400 W MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1804
Mailing Address - Country:US
Mailing Address - Phone:517-265-5444
Mailing Address - Fax:517-264-5182
Practice Address - Street 1:1400 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1804
Practice Address - Country:US
Practice Address - Phone:517-265-5444
Practice Address - Fax:517-264-5182
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist