Individual
MRS. KELLI DAWN GRISMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
215 2ND ST NE, WATERTOWN, SD 57201-2512
(605) 882-3724
Mailing address
215 2ND ST NE, WATERTOWN, SD 57201-2512
(605) 882-3724
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0169
SD
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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