Provider Demographics
NPI:1073733838
Name:KEIPER, ERIC RICHARD (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:RICHARD
Last Name:KEIPER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:MR
Other - First Name:ERIC
Other - Middle Name:R
Other - Last Name:KEIPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:609 W 40TH ST
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-2665
Mailing Address - Country:US
Mailing Address - Phone:918-691-6788
Mailing Address - Fax:918-514-4437
Practice Address - Street 1:609 W 40TH ST
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-2665
Practice Address - Country:US
Practice Address - Phone:918-691-6788
Practice Address - Fax:918-514-4437
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2015-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist