Individual
BRADLEY KETTERSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3815 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(888) 873-4221
Mailing address
3815 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(888) 873-4221
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102146
MN
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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