Provider Demographics
NPI:1164759536
Name:KEATING, A'NDREA (LMT)
Entity Type:Individual
Prefix:MS
First Name:A'NDREA
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39717 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DESERT HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-7901
Mailing Address - Country:US
Mailing Address - Phone:602-618-7590
Mailing Address - Fax:
Practice Address - Street 1:39717 N 3RD ST
Practice Address - Street 2:
Practice Address - City:DESERT HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85086-7901
Practice Address - Country:US
Practice Address - Phone:602-618-7590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-01354P173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist