Provider Demographics
NPI:1235399429
Name:KEESLER, CHRISTY L (LMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:L
Last Name:KEESLER
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 1:345 DICK RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1800
Mailing Address - Country:US
Mailing Address - Phone:716-681-3333
Mailing Address - Fax:716-681-3037
Practice Address - Street 1:345 DICK RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1800
Practice Address - Country:US
Practice Address - Phone:716-681-3333
Practice Address - Fax:716-681-3037
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020323-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist