Individual
COLLEEN ROSE KELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4861 S 27TH ST, GREENFIELD, WI 53221-2603
(414) 325-3325
(414) 325-3334
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11325-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00920110
MEDICARE RAILROAD
WI
Enumeration date
06/29/2009
Last updated
07/21/2014
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