Individual
KELLY JEZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 GUS THOMASSON RD STE 356, MESQUITE, TX 75150-4051
(972) 613-4182
(972) 686-1837
Mailing address
400 S HENDERSON ST, FORT WORTH, TX 76104-1017
(817) 335-2583
(817) 335-2597
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
50654
TX
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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