MEDICARE: KELSEY ABBOTT 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
1	225100000X	Physical Therapist	CP051353T	TX
2	225100000X	Physical Therapist	20220229429	MO

General Provider Information

NPI Number	:	1598543316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY ABBOTT DPT

Provider Business Mailing Address
First Line	:	555 NORTH BALLAS ROAD
Second Line	:	SUITE 225
City	:	CREVE COEUR
State	:	MO
Zip	:	63141
Country	:	US
Telephone Number	:	314-997-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 NORTH BALLAS ROAD
Second Line	:	SUITE 225
City	:	CREVE COEUR
State	:	MO
Zip	:	63141
Country	:	US
Telephone Number	:	314-997-8700
Fax Number	:

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

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	12/16/2025

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