Provider Demographics
NPI:1659901858
Name:HARRIS, KELSEY ANN (PT, DPT, RPSFC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PT, DPT, RPSFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-4992
Mailing Address - Country:US
Mailing Address - Phone:724-705-4311
Mailing Address - Fax:
Practice Address - Street 1:1159 BAYBERRY DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-4992
Practice Address - Country:US
Practice Address - Phone:724-705-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026453225100000X
PADAPT004604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist