Individual
MARIE KETTERSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 1ST AVE NE, BUFFALO, MN 55313-1568
(763) 682-3005
Mailing address
25 1ST AVE NE, BUFFALO, MN 55313-1568
(763) 682-3005
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5002
MN
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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