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Individual

JACOB KETTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
540 E YOUNG AVE STE E, WARRENSBURG, MO 64093-1250
(660) 262-4795
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP034808T
MO
225100000X
Physical Therapist
PT4666
AR
2251P0200X
Pediatric Physical Therapist

Other

Enumeration date
08/09/2019
Last updated
12/23/2024
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