Provider Demographics
NPI:1265864292
Name:KEINROTH, ABIGAIL J (DPT)
Entity Type:Individual
Prefix:MISS
First Name:ABIGAIL
Middle Name:J
Last Name:KEINROTH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:KALONA
Mailing Address - State:IA
Mailing Address - Zip Code:52247-0535
Mailing Address - Country:US
Mailing Address - Phone:319-656-3177
Mailing Address - Fax:319-656-5241
Practice Address - Street 1:423 B AVE
Practice Address - Street 2:
Practice Address - City:KALONA
Practice Address - State:IA
Practice Address - Zip Code:52247
Practice Address - Country:US
Practice Address - Phone:319-656-3177
Practice Address - Fax:319-656-5241
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist