Individual
MS. STACIE KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
21 SAINT JOSEPH ST, RAPID CITY, SD 57701-2822
(605) 394-1813
(605) 394-6766
Mailing address
300 6TH ST, RAPID CITY, SD 57701-5034
(605) 394-1813
(605) 394-6766
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1168
SD
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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