Provider Demographics
NPI:1609320720
Name:NORWAY, KELSEY REBECCA (PT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:REBECCA
Last Name:NORWAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-9347
Mailing Address - Country:US
Mailing Address - Phone:419-739-4599
Mailing Address - Fax:419-738-5688
Practice Address - Street 1:1010 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-9347
Practice Address - Country:US
Practice Address - Phone:419-739-4599
Practice Address - Fax:419-738-5688
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist