Provider Demographics
NPI:1528708427
Name:DUMOND, KELSEY ANN (DPT)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANN
Last Name:DUMOND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14B MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3202
Mailing Address - Country:US
Mailing Address - Phone:207-713-8783
Mailing Address - Fax:
Practice Address - Street 1:400 ENTERPRISE DR STE 4
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7663
Practice Address - Country:US
Practice Address - Phone:207-303-0612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5643208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation