Provider Demographics
NPI:1184001497
Name:SCHERER, KELSA
Entity Type:Individual
Prefix:
First Name:KELSA
Middle Name:
Last Name:SCHERER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 S COACHLIGHT DR APT 19
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-9119
Mailing Address - Country:US
Mailing Address - Phone:715-563-3122
Mailing Address - Fax:
Practice Address - Street 1:1505 S COACHLIGHT DR APT 19
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-9119
Practice Address - Country:US
Practice Address - Phone:715-563-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14594-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist