Individual
JACKI KETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
570 EGG HARBOR RD STE C4, SEWELL, NJ 08080-2359
(609) 267-9400
(609) 267-9457
Mailing address
4 EVES DR STE A100, MARLTON, NJ 08053-3126
(609) 267-9400
(609) 267-9457
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01691700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA01691700
PROFESSIONAL LICENSE
NJ
Enumeration date
05/16/2018
Last updated
05/16/2018
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