Individual
JASON KELECIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8100 HIGHWOOD DR, BLOOMINGTON, MN 55438-1006
(952) 831-7500
Mailing address
1281 GORMAN AVE, WEST ST PAUL, MN 55118-2429
(952) 240-4014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7064
MN
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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