Individual
KELLY VANDE VEGTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1465 COUNTY RD 101 N, PLYMOUTH, MN 55447
(763) 473-1488
Mailing address
1465 COUNTY RD 101 N, PLYMOUTH, MN 55447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7525
MN
Other
Enumeration date
03/02/2006
Last updated
10/22/2013
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