Individual
MS. KELLY RAE HEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 301-0655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004188
KY
225100000X
Physical Therapist
9815
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100045380
—
KY
Enumeration date
11/13/2006
Last updated
05/12/2015
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