Individual
DR. MANDA LINEA KELLER-ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10691
WI
225100000X
Physical Therapist
Primary
8928
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
10/16/2006
Last updated
11/22/2013
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