Individual
DR. KELLY P SADAUCKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, OCS, CSCS
Contact information
Practice address
18 NORTH MAIN ST, SUITE 215, DRIGGS, ID 83422
(208) 354-1999
Mailing address
230 ASHLEY AVE, DRIGGS, ID 83422-5210
(208) 473-6053
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2689
ID
Other
Enumeration date
11/10/2010
Last updated
07/01/2013
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