Individual
CHELSEA RENAE STORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 W NORTH 12TH ST, SHELBYVILLE, IL 62565-9554
(217) 774-2111
Mailing address
2044 N US HIGHWAY 45, MASON, IL 62443-2903
(217) 690-3537
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.007889
IL
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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