Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1262450 | TX |
NPI | 1134595192 |
---|---|
Provider Name | Kelsey Luensmann |
First Address | San Antonio, TX 78217-1252 |
Second Address | San Antonio, TX 78217-1252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2015 |
Last Update Date | 13/08/2015 |