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General NPI Number Information
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NPI Number | 1023995669
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Entity Type | Individual
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Provider Name | KELSEY BODNAR HALLORAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 584 COUNTY LINE RD W
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City | WESTERVILLE
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State | OH
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Zip | 43082-7295
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Country | US
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Telephone | 614-355-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 ELMWOOD AVE APT B
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City | COLUMBUS
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State | OH
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Zip | 43212-2761
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Country | US
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Telephone | 412-302-1035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT021756
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License Number State | OH
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