Provider Demographics
NPI:1881000396
Name:ADAMS, CHELSEY (LAT, ATC)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3320
Mailing Address - Country:US
Mailing Address - Phone:850-529-4498
Mailing Address - Fax:
Practice Address - Street 1:3410 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3320
Practice Address - Country:US
Practice Address - Phone:850-529-4498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL33062255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer