Provider Demographics
NPI:1447635768
Name:BREEN, CHELSEA (DPT)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BREEN
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 1:1311 AUGUSTA RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6320
Mailing Address - Country:US
Mailing Address - Phone:803-926-7204
Mailing Address - Fax:
Practice Address - Street 1:1900 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-5959
Practice Address - Country:US
Practice Address - Phone:803-926-7204
Practice Address - Fax:803-926-7206
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist