Individual
CYNTHIA VIDA KETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
1435 W. MASON ST., STE. 104, GREEN BAY, WI 54303
(920) 737-4135
(920) 490-9705
Mailing address
618A PAINE ST, KIEL, WI 53042-1042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2595
WI
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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