Provider Demographics
NPI:1730511775
Name:CHELSEA PROFESSIONAL SERVICES
Entity type:Organization
Organization Name:CHELSEA PROFESSIONAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KULAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-593-5709
Mailing Address - Street 1:14650 OLD US 12
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1399
Mailing Address - Country:US
Mailing Address - Phone:734-475-3923
Mailing Address - Fax:734-475-4071
Practice Address - Street 1:14650 OLD US 12
Practice Address - Street 2:SUITE 203
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1399
Practice Address - Country:US
Practice Address - Phone:734-475-3923
Practice Address - Fax:734-475-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty