Provider Demographics
NPI:1043768823
Name:KELLEHER, KELSEY (DPT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:KELLEHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CORPORATE CENTER DR STE 115
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4332
Mailing Address - Country:US
Mailing Address - Phone:412-299-0704
Mailing Address - Fax:412-299-2823
Practice Address - Street 1:100 CORPORATE CENTER DR STE 115
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108
Practice Address - Country:US
Practice Address - Phone:412-299-0704
Practice Address - Fax:412-299-2823
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist