Individual
KELSEY MERRITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
640 CONCORD AVE, CAMBRIDGE, MA 02138-1116
(617) 497-0600
Mailing address
1933 COMMONWEALTH AVE APT 305, BRIGHTON, MA 02135-5940
(151) 846-9587
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23025
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23025
PT LICENSE
MA
Enumeration date
12/31/2018
Last updated
12/31/2018
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