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Individual

KELLY SEIDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
600 MEDICAL DR, SUITE 109, WENTZVILLE, MO 63385-3426
(636) 327-1170
Mailing address
600 MEDICAL DR, SUITE 109, WENTZVILLE, MO 63385-3426

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2008036993
MO

Other

Enumeration date
07/27/2010
Last updated
07/27/2010
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