Individual
KELLY GOTBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
854 WASHINGTON AVE STE 200, HOLLAND, MI 49423-7143
(616) 392-9430
Mailing address
5380 LAKE MICHIGAN DR, ALLENDALE, MI 49401-9484
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501018868
MI
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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