Provider Demographics
NPI:1356743488
Name:MILLER, KELSEY ELISABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELISABETH
Last Name:MILLER
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 1:13121 E. 17TH AVE., C234
Mailing Address - Street 2:EDUCATION 2 SOUTH, 5TH FLOOR
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:303-724-7643
Mailing Address - Fax:303-724-7664
Practice Address - Street 1:13121 E. 17TH AVE., C234
Practice Address - Street 2:EDUCATION 2 SOUTH, 5TH FLOOR
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:303-724-7643
Practice Address - Fax:303-724-7664
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0012882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist