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NPI Code Detail

MEDICARE: KELSIE WILBON PT, DPT

MEDICARE: KELSIE WILBON PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501304074MI

General Provider Information

NPI Number : 1275410011
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSIE WILBON PT, DPT
Provider Business Mailing Address
First Line : 52900 GARFIELD RD
Second Line :
City : MACOMB
State : MI
Zip : 48042-3573
Country : US
Telephone Number : 586-991-1399
Fax Number : 586-218-3111
Provider Business Practice Location Address
First Line : 52900 GARFIELD RD
Second Line :
City : MACOMB
State : MI
Zip : 48042-3573
Country : US
Telephone Number : 586-991-1399
Fax Number : 586-218-3111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2025
Last Update Date : 03/04/2026

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Directions to “ KELSIE WILBON PT, DPT” Practice Location

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