Provider Demographics
NPI:1891135976
Name:KELSEY, ALYSON MAY (MED, LAT)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:MAY
Last Name:KELSEY
Suffix:
Gender:F
Credentials:MED, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 MONROE ST
Mailing Address - Street 2:ATTN: SPORTS MEDICINE
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2051
Mailing Address - Country:US
Mailing Address - Phone:608-262-3630
Mailing Address - Fax:
Practice Address - Street 1:1440 MONROE ST
Practice Address - Street 2:ATTN: SPORTS MEDICINE
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2051
Practice Address - Country:US
Practice Address - Phone:608-262-3630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260018412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer