Individual
JACOB KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2835 E BROWN RD STE 101, MESA, AZ 85213-5470
(480) 807-6644
Mailing address
2835 E BROWN RD STE 101, MESA, AZ 85213-5470
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13450
AZ
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
12/06/2017
Last updated
04/09/2021
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