Individual
MRS. KELLY CHRISTINE FIESELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
23580 SHAKER BLVD, SHAKER HEIGHTS, OH 44122-2605
(216) 491-8407
Mailing address
23580 SHAKER BLVD, SHAKER HEIGHTS, OH 44122-2605
(216) 491-8407
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT9611
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000247980
ANTHEM
OH
05
—
2382505
—
OH
01
—
341907722
UNITED HEALTHCARE
OH
01
—
34190772200
WORKERS COMPENSATION
OH
Enumeration date
06/03/2006
Last updated
06/12/2015
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