Individual
KELLIE JAKUBOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3676 PARKER BLVD, PUEBLO, CO 81008-2212
(719) 553-1804
(833) 916-2057
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-2200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL0003527
CO
Other
Enumeration date
04/24/2024
Last updated
12/13/2024
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