DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MRS. DEANNA SUE KELLY PTA

MEDICARE: MRS. DEANNA SUE KELLY PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant1283-19WI

General Provider Information

NPI Number : 1598036535
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEANNA SUE KELLY PTA
Provider Business Mailing Address
First Line : 4942 THOMPSON RD
Second Line :
City : HERMANTOWN
State : MN
Zip : 55811-3743
Country : US
Telephone Number : 218-341-5810
Fax Number :
Provider Business Practice Location Address
First Line : 35 N 28TH ST
Second Line :
City : SUPERIOR
State : WI
Zip : 54880-5557
Country : US
Telephone Number : 715-392-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2012
Last Update Date : 01/23/2012

Similar Medicare Providers

1134123573 — VILLA MARINA HEALTH AND REHABILITATION CENTER INC
Practice Location Address:
35 NORTH 28TH STREET
SUPERIOR, WI
54880-5557
Practice Phone: 715-392-3300
Practice Fax: 715-392-9660
1184883423 — MRS. RACHEL NICOLE URSIN-SCHIFF MS/CCC SLP
Practice Location Address:
35 N 28TH ST
SUPERIOR, WI
54880-5557
Practice Phone: 715-395-3300
Practice Fax:
1477897825 — AMY JO FOLKESTAD COTA/L
Practice Location Address:
35 N 28TH ST
SUPERIOR, WI
54880-5557
Practice Phone: 715-392-3300
Practice Fax:
1366787368 — THERESA A KUCERA COTA
Practice Location Address:
35 N 28TH ST
SUPERIOR, WI
54880-5557
Practice Phone: 715-392-3300
Practice Fax:
1336523562 — NICOLE KELLY
Practice Location Address:
35 N 28TH ST
SUPERIOR, WI
54880-5557
Practice Phone: 715-392-3300
Practice Fax:
1407373335 — LEEANNA MAE RUPRECHT COTA
Practice Location Address:
35 N 28TH ST
SUPERIOR, WI
54880-5557
Practice Phone: 715-392-3300
Practice Fax:

Directions to “ MRS. DEANNA SUE KELLY PTA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.