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Individual

THERESA L KELSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPT

Contact information

Practice address
123 FRONTIER BLVD STE 106, STANFORD, KY 40484
(606) 257-0005
(606) 262-4132
Mailing address
1464 AMSTER GROVE RD, WINCHESTER, KY 40391-8073

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003869
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100508700
KY
Enumeration date
07/14/2006
Last updated
05/14/2018
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