Provider Demographics
NPI:1689006231
Name:GILMAN, KELSEY ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ANN
Last Name:GILMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 PHARR RD NE
Mailing Address - Street 2:APT 118
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2350
Mailing Address - Country:US
Mailing Address - Phone:973-632-9033
Mailing Address - Fax:
Practice Address - Street 1:6505 SHILOH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8405
Practice Address - Country:US
Practice Address - Phone:678-648-7644
Practice Address - Fax:678-648-7479
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0110972251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics