Provider Demographics
NPI:1437508462
Name:SCHWARTZ, KELSIE M (DPT)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KELSIE
Other - Middle Name:M
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2812 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6202
Mailing Address - Country:US
Mailing Address - Phone:620-208-7878
Mailing Address - Fax:620-208-7000
Practice Address - Street 1:2812 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6202
Practice Address - Country:US
Practice Address - Phone:620-208-7878
Practice Address - Fax:620-208-7000
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1105379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist