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Tyler Kettelkamp, ATC
NPI 1235372731 · on the registry since 2009
Practice
- Address
- 8559 Edinbrook Pkwy
104
Brooklyn Park, MN 55443 - Phone
- (763) 425-5461
- Organisation at this address
- Pdg,P.A.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 15
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Sex
- Male
- Record last updated
- 2009-04-14
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota