Provider Demographics
NPI:1053694331
Name:TOOLE, CHELSEA (DPT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:TOOLE
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 1:21015 PATHFINDER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4002
Mailing Address - Country:US
Mailing Address - Phone:909-861-3511
Mailing Address - Fax:
Practice Address - Street 1:21015 PATHFINDER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4018
Practice Address - Country:US
Practice Address - Phone:909-861-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist