Provider Demographics
NPI:1548631682
Name:CHELSVIG, RONALD (PT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:CHELSVIG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 LOTUS RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2345
Mailing Address - Country:US
Mailing Address - Phone:610-880-3738
Mailing Address - Fax:
Practice Address - Street 1:10501 ACADEMY RD
Practice Address - Street 2:UNIT N
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1137
Practice Address - Country:US
Practice Address - Phone:215-743-4435
Practice Address - Fax:215-743-8750
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008020L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist