Provider Demographics
NPI:1518542505
Name:BAUSPIES, KELSEY LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNN
Last Name:BAUSPIES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 W KNAPP ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-1384
Mailing Address - Country:US
Mailing Address - Phone:715-236-3610
Mailing Address - Fax:
Practice Address - Street 1:1507 W KNAPP ST UNIT 1
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-1384
Practice Address - Country:US
Practice Address - Phone:715-236-3610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant