Provider Demographics
NPI:1720447881
Name:KUEHN, KELSEY (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:
Last Name:KUEHN
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4525
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-4525
Mailing Address - Country:US
Mailing Address - Phone:719-221-9830
Mailing Address - Fax:719-890-3913
Practice Address - Street 1:529 GOLD STREET
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211
Practice Address - Country:US
Practice Address - Phone:719-221-9830
Practice Address - Fax:719-890-3913
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0013801OtherPHYSICAL THERAPY LICENSE