Provider Demographics
NPI:1023501384
Name:TUNNEY, KELSEY MARIE-TAELOUR (DPT/LMT)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:MARIE-TAELOUR
Last Name:TUNNEY
Suffix:
Gender:F
Credentials:DPT/LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5578 LONGLEY LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1825
Mailing Address - Country:US
Mailing Address - Phone:775-284-8650
Mailing Address - Fax:775-432-2339
Practice Address - Street 1:2385 E PRATER WAY STE 204
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9688
Practice Address - Country:US
Practice Address - Phone:775-284-8650
Practice Address - Fax:775-284-8654
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist