Provider Demographics
NPI:1851760375
Name:GRANLEY, KELSEY (DPT)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:
Last Name:GRANLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32713 TERRACE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-9889
Mailing Address - Country:US
Mailing Address - Phone:406-261-2312
Mailing Address - Fax:
Practice Address - Street 1:701 SESAME ST STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6647
Practice Address - Country:US
Practice Address - Phone:907-561-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist