Provider Demographics
NPI:1609156835
Name:KELTGEN, KELSEY MARIE (OD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:KELTGEN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 ARBORETUM BLVD
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-3300
Mailing Address - Country:US
Mailing Address - Phone:612-800-7335
Mailing Address - Fax:612-800-7336
Practice Address - Street 1:2160 ARBORETUM BLVD
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:MN
Practice Address - Zip Code:55386-3300
Practice Address - Country:US
Practice Address - Phone:612-800-7335
Practice Address - Fax:612-800-7336
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3237152W00000X
MN0003237152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist