Provider Demographics
NPI:1659390334
Name:KESSLER, MICHAEL R (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:R
Last Name:KESSLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5890
Mailing Address - Fax:740-446-5532
Practice Address - Street 1:313 MACCORKLE AVE SW
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1263
Practice Address - Country:US
Practice Address - Phone:304-744-2300
Practice Address - Fax:304-744-5891
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV000870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0156351000Medicaid
OH2229501OtherMOLINA MEDICAID #
1659390334OtherNPI
000000217253OtherANTHEM BCBS
000000217253OtherANTHEM BCBS