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General NPI Number Information
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NPI Number | 1720396724
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Entity Type | Organization
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Legal Business Name | KELSEY ENTERPRISES LLC
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 215 NW CENTRAL AVE
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City | AMITE
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State | LA
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Zip | 70422
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Country | US
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Telephone | 985-747-3422
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Fax | 985-747-3424
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Provider Business Mailing Address
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Address Line | 215 NW CENTRAL AVE
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City | AMITE
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State | LA
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Zip | 70422
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Country | US
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Telephone | 985-747-3422
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Fax | 985-747-3424
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | BRENNAN KELSEY
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Credential |
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Telephone | 985-747-3422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 02637
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License Number State | LA
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