Provider Demographics
NPI:1013509421
Name:COMEAU, CHELSEA TAYLOR (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:TAYLOR
Last Name:COMEAU
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 FOX CHASE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2517
Mailing Address - Country:US
Mailing Address - Phone:405-637-7509
Mailing Address - Fax:
Practice Address - Street 1:4100 WELL SPRING DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8857
Practice Address - Country:US
Practice Address - Phone:336-545-5416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-07
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist