MEDICARE: KELSEY MELSHEIMER OTR/L

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1346709896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY MELSHEIMER OTR/L

Provider Business Mailing Address
First Line	:	1562 HIGHWAY J
Second Line	:
City	:	WRIGHT CITY
State	:	MO
Zip	:	63390-1622
Country	:	US
Telephone Number	:	636-675-4160
Fax Number	:

Provider Business Practice Location Address
First Line	:	1335 STRASSNER DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63144-1872
Country	:	US
Telephone Number	:	844-502-7996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2019
Last Update Date	:	04/08/2022

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