Individual
ALYSSA KETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST # T, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
1000 W CARSON ST, TORRANCE, CA 90502-2004
(310) 222-2345
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
78809
MN
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
A187029
CA
Other
Enumeration date
03/25/2020
Last updated
08/18/2025
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