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Individual

MS. KACEY MARIE JACQUES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1889 WOODMOOR DR, MONUMENT, CO 80132-9066
(719) 481-6868
Mailing address
6340 VARIEL AVE, WOODLAND HILLS, CA 91367-2514
(818) 888-1255

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL0015090
CO
2251E1200X
Ergonomics Physical Therapist
14531
CA
2251P0200X
Pediatric Physical Therapist
14531
CA
2251S0007X
Sports Physical Therapist
14531
CA
2251X0800X
Orthopedic Physical Therapist
14531
CA

Other

Enumeration date
02/22/2010
Last updated
03/10/2026
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