Individual
MISS KELLY NICOLE RICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ATC
Contact information
Practice address
3580 ARCADE ST, VADNAIS HEIGHTS, MN 55127-7135
(651) 968-5201
Mailing address
84 WATER ST W APT 311, SAINT PAUL, MN 55107-4403
(605) 553-2302
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
0543
SD
2255A2300X
Athletic Trainer
Primary
3429
MN
Other
Enumeration date
09/03/2020
Last updated
01/27/2022
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