Provider Demographics
NPI:1770987976
Name:ULRICH, KELSEY MEGHAN (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:MEGHAN
Last Name:ULRICH
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 PEACHTREE CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6705
Mailing Address - Country:US
Mailing Address - Phone:484-794-0969
Mailing Address - Fax:
Practice Address - Street 1:1418 S POWERLINE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-4300
Practice Address - Country:US
Practice Address - Phone:975-954-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-16
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0053162255A2300X
FLPT37366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer