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NPI Code Detail

MEDICARE: KELSEY FROMAN PT, DPT

MEDICARE: KELSEY FROMAN 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 Therapist7010KY

General Provider Information

NPI Number : 1942742788
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY FROMAN PT, DPT
Provider Business Mailing Address
First Line : 190 SHADOWMEADE LN STE 400
Second Line :
City : MT WASHINGTON
State : KY
Zip : 40047-6277
Country : US
Telephone Number : 502-538-2332
Fax Number : 502-538-2514
Provider Business Practice Location Address
First Line : 190 SHADOWMEADE LN STE 400
Second Line :
City : MT WASHINGTON
State : KY
Zip : 40047-6277
Country : US
Telephone Number : 502-538-2332
Fax Number : 502-538-2514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2016
Last Update Date : 08/27/2019

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