Shasta Ketchamconnelly, DPT

NPI #1104276120 in Danville, Iowa

Provider Information

NPI Number
1104276120
Entity Type
Individual
Name
Shasta Ketchamconnelly, DPT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Therapist
Credential
DPT
Enumeration Date
Jun 21, 2016
Last Updated
Jun 21, 2016

Practice Location

Address
508 S 1ST AVE
State
Iowa
ZIP Code
52623-9609
Phone
(319) 750-2799

Specialties & Taxonomy Codes

Specialty
Physical Therapist

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