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General NPI Number Information
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NPI Number | 1306598487
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Entity Type | Individual
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Provider Name | KELSEY ROSE DAYLAND
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 2817 NEW PINERY RD
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City | PORTAGE
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State | WI
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Zip | 53901-9240
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Country | US
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Telephone | 608-745-6290
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Fax |
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Provider Business Mailing Address
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Address Line | 319 VALLEY GLEN CT
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City | BARABOO
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State | WI
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Zip | 53913-8941
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Country | US
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Telephone | 563-542-8454
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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 | 15573-24
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License Number State | WI
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