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Individual

KELSEY LYN KETELSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, MSPT

Contact information

Practice address
621 TOPAZ ST, KEMMERER, WY 83101-3445
(307) 679-4894
Mailing address
621 TOPAZ ST, KEMMERER, WY 83101-3445
(307) 679-4894

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0016556
CO
225100000X
Physical Therapist
0999
WY
225100000X
Physical Therapist
Primary
1326976
TX
225100000X
Physical Therapist
19316
NC
225100000X
Physical Therapist
2305212668
VA

Other

Enumeration date
07/10/2020
Last updated
07/10/2020
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