Individual
MRS. BRANDI LYNNE KETTERLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17630 HEMLOCK AVE, LAKEVILLE, MN 55044-3908
(952) 484-3974
Mailing address
17630 HEMLOCK AVE, LAKEVILLE, MN 55044-3908
(952) 484-3974
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A194
MN
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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