Healthcare Provider Details

I. General information

NPI: 1679260145
Provider Name (Legal Business Name): KELSEY ELIZABETH AIKENS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ROBINSON ST STE D300
BASALT CO
81621-8474
US

IV. Provider business mailing address

PO BOX 40000
VAIL CO
81658-7520
US

V. Phone/Fax

Practice location:
  • Phone: 970-718-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019031
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: