Healthcare Provider Details

I. General information

NPI: 1598543316
Provider Name (Legal Business Name): KELSEY ABBOTT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 NORTH BALLAS ROAD SUITE 225
CREVE COEUR MO
63141
US

IV. Provider business mailing address

555 NORTH BALLAS ROAD SUITE 225
CREVE COEUR MO
63141
US

V. Phone/Fax

Practice location:
  • Phone: 314-997-8700
  • Fax:
Mailing address:
  • Phone: 314-997-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP051353T
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20220229429
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: