Provider Demographics
NPI:1114234689
Name:HELUS, JACQUELYNN MARIE (PTA)
Entity Type:Individual
Prefix:MS
First Name:JACQUELYNN
Middle Name:MARIE
Last Name:HELUS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 S. RANGE
Mailing Address - Street 2:STE 8
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701
Mailing Address - Country:US
Mailing Address - Phone:785-460-7848
Mailing Address - Fax:785-460-7849
Practice Address - Street 1:990 S. RANGE
Practice Address - Street 2:STE 8
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701
Practice Address - Country:US
Practice Address - Phone:785-460-7848
Practice Address - Fax:785-460-7849
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00325225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant