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1467770768
KELLY DIRKSE
BROOKFIELD, WI
NPI
1467770768
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Former Name
KELLY MAINS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 3935)
Enumeration Date
2010-05-11
Last Update Date
2010-05-11
Business Address
-- KELLY DIRKSE PT
17280 W NORTH AVE #104
BROOKFIELD, WI 53045-4366
Phone number: 262-780-0707
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Mailing Address
-- KELLY DIRKSE PT
17280 W NORTH AVE #104
BROOKFIELD, WI 53045-4366
Phone number: 262-780-0707
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