Individual
KELSEY A DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
ST CLOUD HOSPITAL, 1406 6TH AVENUE NORTH, ST CLOUD, MN 56303-1901
(320) 251-2700
(320) 656-7115
Mailing address
ST CLOUD HOSPITAL, 1406 6TH AVENUE NORTH, ST CLOUD, MN 56303-1901
(320) 251-2700
(320) 656-7115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9786
MN
Other
Enumeration date
02/16/2017
Last updated
07/06/2018
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