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Individual

CHELSEA S PINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
904 CHARLESTON WAY DR, WESTERVILLE, OH 43081-5591
(740) 751-5228
Mailing address
904 CHARLESTON WAY DR, WESTERVILLE, OH 43081-5591
(740) 751-5228

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
000321
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1356868038
OH
Enumeration date
08/24/2017
Last updated
09/03/2019
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