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1902354871
STACIE KELLOGG
RAPID CITY, SD
NPI
1902354871
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: SD 1168)
Enumeration Date
2016-09-20
Last Update Date
2016-09-20
Business Address
Ms. STACIE KELLOGG MPT
21 SAINT JOSEPH ST
RAPID CITY, SD 57701-2822
Phone number: 605-394-1813
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Mailing Address
Ms. STACIE KELLOGG MPT
300 6TH ST
RAPID CITY, SD 57701-5034
Phone number: 605-394-1813
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