Provider Demographics
NPI:1801368121
Name:KESSEL, MARIA TERESA REMOLANA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARIA TERESA
Middle Name:REMOLANA
Last Name:KESSEL
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 1:3407 FOOTHILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-2222
Mailing Address - Country:US
Mailing Address - Phone:307-257-7173
Mailing Address - Fax:
Practice Address - Street 1:300 S BURMA AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3415
Practice Address - Country:US
Practice Address - Phone:307-688-6230
Practice Address - Fax:307-688-6210
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY0958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist