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Individual

MRS. KELIE JEAN DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
15 8TH AVE N, HOPKINS, MN 55343
(952) 933-5085
(952) 931-2159
Mailing address
15 8TH AVE N, HOPKINS, MN 55343-7611
(952) 933-5085
(952) 931-2159

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7809
MN
2255A2300X
Athletic Trainer
1937
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046953200
MN
Enumeration date
09/19/2006
Last updated
09/04/2018
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