| Doctor Name: | MRS. ELLYNN MARIE KOELSCH |
| NPI Number: | 1720229297 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | PT02199 |
| Business Practice Address: | 400 Massasoit Avenue Suite 203 Silver Fern Practice Dba Performance Physical East Providence, RI - 02914 |
| Business Phone Number: | 4012708770 |
| Business Fax Number: | 4012708772 |
| Mailing Address: | 1525 Wampanoag Trail, Suite 205 Silver Fern Practice Dba Performance Physical EAST PROVIDENCE |
| State: | RI |
| Postal Code: | 02915 |
| Phone Number: | 4014334049 |
| Fax Number: | 4014330612 |
| NPI Enumeration Date: | 03/13/2009 |
| NPI Last Update Date: | 03/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT02199 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |