MEDICARE: KELSEY MARIE BELSHER

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	2255A2300X	Athletic Trainer	AT.0001290	CO

General Provider Information

NPI Number	:	1982293981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY MARIE BELSHER

Provider Business Mailing Address
First Line	:	1880 OFFICE CLUB PT STE 1740
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-5008
Country	:	US
Telephone Number	:	719-237-7751
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 OFFICE CLUB PT STE 1740
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-5008
Country	:	US
Telephone Number	:	719-237-7751
Fax Number	:

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

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	01/13/2021

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