Provider Demographics
NPI:1265820872
Name:KEATING, ROBIN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 BROADMOOR DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2903
Mailing Address - Country:US
Mailing Address - Phone:870-508-7530
Mailing Address - Fax:870-508-1617
Practice Address - Street 1:610 BROADMOOR DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2903
Practice Address - Country:US
Practice Address - Phone:870-508-7530
Practice Address - Fax:870-508-1617
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2441225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist