Kettelkamp, Tyler Steven

Kettelkamp, Tyler Steven is an individual health care provider with primary practice located at 8559 Edinbrook Pkwy 104, Brooklyn Park MN 55443-3747. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Kettelkamp, Tyler Steven can be contacted via phone (763) 425-5461.

Contact Information

Primary practice address
8559 Edinbrook Pkwy 104 Brooklyn Park MN 55443-3747
Phone: (763) 425-5461
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1235372731
LBN Legal business name Kettelkamp, Tyler Steven
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2009
Last updated Apr 14th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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