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General NPI Number Information
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NPI Number | 1083610604
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Entity Type | Individual
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Provider Name | BRIAN SCOTT KELSEY C.P.O.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 6790 WEST LAYTON AVENUE
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City | GREENFIELD
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State | WI
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Zip | 53220-4571
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Country | US
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Telephone | 414-282-3100
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Fax | 414-282-3101
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Provider Business Mailing Address
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Address Line | 6790 WEST LAYTON AVENUE
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City | GREENFIELD
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State | WI
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Zip | 53220-4571
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Country | US
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Telephone | 414-282-3100
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Fax | 414-282-3101
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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