Kelli Tracy Jackman MPT

NPI 1750698114 - Physical Therapist - 2251P0200X

NPI Details
NPI 1750698114
Gender Female
Enumeration Date 09/08/2010
Last Updated 09/08/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
981 DOWLING BLVD
SAN LEANDRO CA, 94577-2125, US
Phone (510) 638-9618
Fax
Business Location
981 DOWLING BLVD
SAN LEANDRO CA, 94577-2125, US
Phone (510) 638-9618
Fax
Toxanomy
Taxonomy Code 2251P0200X
License State California
License Number PT 28294
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According to our database, Kelli Tracy Jackman MPT NPI is 1750698114, taxonomy code is 2251P0200X and license number is PT 28294, license state is located at California. Kelli Tracy Jackman MPT physically located at 981 Dowling Blvd, San Leandro CA, 94577-2125. NPI Number Kelli Tracy Jackman MPT has the Individual type.

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1750698114 NPI number is provided on an as is basis without warranty of any kind. 1750698114 is maintained by the National Plan & Provider Enumeration System. The contents of Kelli Tracy Jackman MPT are for informational purposes only.