Provider Demographics
NPI:1245030592
Name:EDGAR, CHELSEA J (LMT)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:J
Last Name:EDGAR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:WHITEFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04353-3200
Mailing Address - Country:US
Mailing Address - Phone:207-242-1875
Mailing Address - Fax:
Practice Address - Street 1:400 CHRISTIAN RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-3218
Practice Address - Country:US
Practice Address - Phone:207-242-1875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT7479225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist