Provider Demographics
NPI:1093196248
Name:HALSTEAD, KELSEY L (DPT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:L
Last Name:HALSTEAD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:L
Other - Last Name:BRUMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 382
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82602-0382
Mailing Address - Country:US
Mailing Address - Phone:307-277-1283
Mailing Address - Fax:307-337-1279
Practice Address - Street 1:115 S ELM ST STE 102
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2599
Practice Address - Country:US
Practice Address - Phone:217-821-1727
Practice Address - Fax:307-337-1279
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist