Healthcare Provider Details

I. General information

NPI: 1578901294
Provider Name (Legal Business Name): KELLY STURM DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY REED

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 AZTEC DR STE B
EDEN PRAIRIE MN
55347-1916
US

IV. Provider business mailing address

502 SAXON DR
ELKO NEW MARKET MN
55054-4712
US

V. Phone/Fax

Practice location:
  • Phone: 612-234-1811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9410
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: