Individual
KELLY JO GAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 ROSSMAN AVE, DETROIT LAKES, MN 56501-3826
(218) 847-9268
Mailing address
1841 BRAINARD BLVD, DETROIT LAKES, MN 56501-7987
(218) 847-9268
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102918
MN
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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