Individual
KELLY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
801 S BRIGGS ST, 2ND FLOOR, JOLIET, IL 60433-9591
(815) 722-1757
(815) 722-1767
Mailing address
801 S BRIGGS ST, 2ND FLOOR, JOLIET, IL 60433-9591
(815) 722-1757
(815) 722-1767
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006882
IL
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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