Provider Demographics
NPI:1730755356
Name:JENTSCH, CHELSEA LEE (DPT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LEE
Last Name:JENTSCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5033 OAKMERE RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-0296
Mailing Address - Country:US
Mailing Address - Phone:716-983-4257
Mailing Address - Fax:
Practice Address - Street 1:5950 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3104
Practice Address - Country:US
Practice Address - Phone:980-299-7853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist