Healthcare Provider Details

I. General information

NPI: 1891635686
Provider Name (Legal Business Name): KELSEY ANN SELMAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N NEWTON AVE
EL DORADO AR
71730-5421
US

IV. Provider business mailing address

215 N NEWTON AVE
EL DORADO AR
71730-5421
US

V. Phone/Fax

Practice location:
  • Phone: 870-863-5100
  • Fax:
Mailing address:
  • Phone: 870-863-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4532
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: