MEDICARE: KELSEY LAPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	004774	WV

General Provider Information

NPI Number	:	1083594600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY LAPP

Provider Business Mailing Address
First Line	:	1 DIANE DR
Second Line	:
City	:	FORT ASHBY
State	:	WV
Zip	:	26719-7228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 DIANE DR
Second Line	:
City	:	FORT ASHBY
State	:	WV
Zip	:	26719-7228
Country	:	US
Telephone Number	:	304-298-3602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	10/24/2025

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Directions to “ KELSEY LAPP ” Practice Location

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