Individual
KELSEY JACOBSZOON BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5353 COLUMBUS ST SE, ALBANY, OR 97322-7136
(541) 928-7232
Mailing address
1250 NW 23RD ST APT 9, CORVALLIS, OR 97330-2481
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09513
OR
Other
Enumeration date
07/30/2017
Last updated
07/30/2017
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