Individual
KENNETH MARK JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2525 N GRANDVIEW AVE, 400, ODESSA, TX 79761-1600
(432) 550-4700
(432) 550-4715
Mailing address
2525 N GRANDVIEW AVE, 400, ODESSA, TX 79761-1600
(432) 550-4700
(432) 550-4715
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4043303
TX
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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