Individual
KELSEY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 E 200 N, BOUNTIFUL, UT 84010-4707
(801) 829-8823
Mailing address
159 E 200 N, BOUNTIFUL, UT 84010-4707
(801) 829-8823
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8827724-2401
UT
Other
Enumeration date
01/15/2014
Last updated
02/07/2014
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