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General NPI Number Information
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NPI Number | 1619513520
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Entity Type | Individual
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Provider Name | KELSEY HAGERDON PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 1525 GENNTOWN DR STE A6
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City | LEBANON
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State | OH
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Zip | 45036-7323
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Country | US
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Telephone | 513-970-7230
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Fax | 513-970-7231
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Provider Business Mailing Address
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Address Line | 1525 GENNTOWN DR STE A6
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City | LEBANON
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State | OH
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Zip | 45036-7323
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Country | US
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Telephone | 513-970-7230
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Fax | 513-970-7231
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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 | PT021933
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License Number State | OH
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