Individual
STEPHANIE JANE KELSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.T.
Contact information
Practice address
212 W VAN DORN ST.,, STE D, POLK CITY, IA 50226-0142
(515) 984-6377
(515) 984-6782
Mailing address
850 43RD AVE STE 100, MOLINE, IL 61265-8401
(309) 743-2070
(309) 743-2073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03561
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03561
PHYSICAL THERAPY LICENSE
IA
Enumeration date
08/13/2006
Last updated
04/12/2012
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