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NPI Code Detail

MEDICARE: KELSEY RAE ROSEBROCK PT, DPT

MEDICARE: KELSEY RAE ROSEBROCK 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 Therapist2319SD

General Provider Information

NPI Number : 1801467865
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY RAE ROSEBROCK PT, DPT
Provider Business Mailing Address
First Line : 4901 W 37TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-1113
Country : US
Telephone Number : 605-351-7861
Fax Number :
Provider Business Practice Location Address
First Line : 6800 S LOUISE AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57108-6026
Country : US
Telephone Number : 605-504-2472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2021
Last Update Date : 10/28/2025

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