Provider Demographics
NPI:1013624378
Name:GALLOWAY, CHELSEA ASHTON (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:ASHTON
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ASHTON
Other - Last Name:CULBERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:5010 TROTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5010 TROTWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5074
Practice Address - Country:US
Practice Address - Phone:731-431-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4993208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4993OtherPTA