Provider Demographics
NPI:1972863603
Name:ARTMAN, KELSEY MARIE (PTA)
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:MARIE
Last Name:ARTMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2222 S FRONTAGE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-5271
Mailing Address - Country:US
Mailing Address - Phone:601-456-0159
Mailing Address - Fax:601-456-0232
Practice Address - Street 1:2222 S FRONTAGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-5271
Practice Address - Country:US
Practice Address - Phone:601-456-0159
Practice Address - Fax:601-456-0232
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant