Individual
KAITLYN M KESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058213
—
OH
01
—
310917085167
OH MEDICAID CARESOURCE
OH
05
—
3810021348
—
WV
Enumeration date
06/16/2011
Last updated
05/11/2020
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