Provider Demographics
NPI:1457012866
Name:GAFFNEY, KELSEY (DPT)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:
Last Name:GAFFNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6356 GOSHEN RD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:OH
Mailing Address - Zip Code:45122-9215
Mailing Address - Country:US
Mailing Address - Phone:513-532-3507
Mailing Address - Fax:
Practice Address - Street 1:2600 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-1590
Practice Address - Country:US
Practice Address - Phone:859-572-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-32148225100000X
OHPT019959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist