Individual
KELLEY M VONDERHEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
255 W 36TH ST STE 100, JASPER, IN 47546-7850
(812) 482-7755
(812) 482-7757
Mailing address
1020 11TH ST STE C, TELL CITY, IN 47586-2130
(812) 547-7770
(812) 547-7784
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013795A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05013795A
PHYSICAL THERAPY LICENSE
IN
Enumeration date
11/03/2020
Last updated
11/03/2020
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