Provider Demographics
NPI:1962969535
Name:HEBDEN, KELSEY FAY (DPT, PT)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:FAY
Last Name:HEBDEN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 W GROVE ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:PA
Mailing Address - Zip Code:18517-2207
Mailing Address - Country:US
Mailing Address - Phone:570-986-4515
Mailing Address - Fax:
Practice Address - Street 1:214 6TH ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1801
Practice Address - Country:US
Practice Address - Phone:570-228-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist