Provider Demographics
NPI:1447039029
Name:KLINKSIEK, CHELSEA ANN (LMT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:KLINKSIEK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 SUGARBUSH TRL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-7000
Mailing Address - Country:US
Mailing Address - Phone:502-552-3572
Mailing Address - Fax:
Practice Address - Street 1:216 N LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1015
Practice Address - Country:US
Practice Address - Phone:502-552-3572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY266950225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist