Provider Demographics
NPI:1710378252
Name:FEARN, CHELSEA (PT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:FEARN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:MCGOWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1076 RIBAUT RD
Mailing Address - Street 2:STE 102
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5490
Mailing Address - Country:US
Mailing Address - Phone:843-521-1970
Mailing Address - Fax:843-521-0908
Practice Address - Street 1:1076 RIBAUT RD
Practice Address - Street 2:STE 102
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902
Practice Address - Country:US
Practice Address - Phone:843-521-1970
Practice Address - Fax:843-521-0908
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist