Provider Demographics
NPI:1720745557
Name:FISHER, KELSEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:MARVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1821 PHOENIX AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-7939
Mailing Address - Country:US
Mailing Address - Phone:479-222-1924
Mailing Address - Fax:479-358-1455
Practice Address - Street 1:1821 PHOENIX AVE STE A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-7939
Practice Address - Country:US
Practice Address - Phone:479-222-1924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist