Kelly, Jennifer Marie

Kelly, Jennifer Marie is an individual health care provider with primary practice located at 55 Nw Wall St Ste 100 0, Bend OR 97703-3200. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Kelly, Jennifer Marie can be contacted via phone (541) 389-4321.

Contact Information

Primary practice address
55 Nw Wall St Ste 100 0 Bend OR 97703-3200
Phone: (541) 389-4321
Fax: (541) 389-4420
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 4483 Oregon
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1723 Alaska
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2421 Nebraska

Profile Details

NPI number 1417931817
LBN Legal business name Kelly, Jennifer Marie
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Oct 7th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417931817 NPPES
Oregon MEDICAID 299148

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