Provider Demographics
NPI:1336785351
Name:IGLESIAS, CHELSEA (ATC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:IGLESIAS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2463 AUGUSTA HWY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2296
Mailing Address - Country:US
Mailing Address - Phone:803-821-3438
Mailing Address - Fax:
Practice Address - Street 1:2463 AUGUSTA HWY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2296
Practice Address - Country:US
Practice Address - Phone:803-821-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer