Provider Demographics
NPI:1437831179
Name:MANN, KELSEY (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 PLANT AVE APT A
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-1950
Mailing Address - Country:US
Mailing Address - Phone:919-757-3130
Mailing Address - Fax:
Practice Address - Street 1:1035 AVIATION BLVD
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-4023
Practice Address - Country:US
Practice Address - Phone:310-937-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist