Kettner, Jacob

Kettner, Jacob is an sole proprietor health care provider with primary practice located at 3399 Black Forest Dr Ste 3 , Fayetteville AR 72704-6541. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is his primary health care specialty. Kettner, Jacob can be contacted via phone (417) 300-9965.

Contact Information

Primary practice address
3399 Black Forest Dr Ste 3 Fayetteville AR 72704-6541
Phone: (417) 300-9965
Fax: (417) 494-4173
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT4666 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X

Profile Details

NPI number 1225683808
LBN Legal business name Kettner, Jacob
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2019
Last updated Oct 18th, 2023 - about 2 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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