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General NPI Number Information
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NPI Number | 1508414962
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Entity Type | Individual
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Provider Name | KELSEY KENNEDY SMITH PT
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 7060 HIGHLAND DR
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City | PITTSBURGH
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State | PA
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Zip | 15206-1259
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Country | US
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Telephone | 818-506-8212
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Fax |
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Provider Business Mailing Address
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Address Line | 421 BEECH DR
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City | MC KEES ROCKS
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State | PA
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Zip | 15136-1430
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Country | US
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Telephone | 317-966-3372
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 05011488A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT032673
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License Number State | PA
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