Provider Demographics
NPI:1972884807
Name:PANNELL, CHELSY (PT)
Entity Type:Individual
Prefix:
First Name:CHELSY
Middle Name:
Last Name:PANNELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHELSY
Other - Middle Name:
Other - Last Name:NEIMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:602 CEREMONY WAY
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-3731
Mailing Address - Country:US
Mailing Address - Phone:772-485-0493
Mailing Address - Fax:
Practice Address - Street 1:110 CHEROKEE PL
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-2954
Practice Address - Country:US
Practice Address - Phone:770-386-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL017035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist