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Individual

MARY R KERKVLIET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
815 S MINNESOTA AVE, SIOUX FALLS, SD 57104-4828
(605) 231-5586
(605) 231-5587
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6250
(630) 575-7450

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13866-24
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11395
PT LICENSE
MN
01
13866-24
PT LICENSE
WI
Enumeration date
06/02/2017
Last updated
07/21/2022
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  • EDI platform