Provider Demographics
NPI:1346903283
Name:BALTZER, KELSEY L (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:L
Last Name:BALTZER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4346 BELLE TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8243
Mailing Address - Country:US
Mailing Address - Phone:513-470-0986
Mailing Address - Fax:
Practice Address - Street 1:4346 BELLE TERRACE LN
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-8243
Practice Address - Country:US
Practice Address - Phone:513-470-0986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist