Provider Demographics
NPI:1518578103
Name:KAUFMANN, KELSEY LYNNE
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNNE
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:
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 154
Mailing Address - Street 2:
Mailing Address - City:FAULKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57438-0154
Mailing Address - Country:US
Mailing Address - Phone:605-203-1771
Mailing Address - Fax:
Practice Address - Street 1:1401 PEARL ST
Practice Address - Street 2:
Practice Address - City:FAULKTON
Practice Address - State:SD
Practice Address - Zip Code:57438-2219
Practice Address - Country:US
Practice Address - Phone:621-460-5598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist