Provider Demographics
NPI:1326324542
Name:HILL, KEITH (BS)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 EMBER LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7666
Mailing Address - Country:US
Mailing Address - Phone:817-929-9856
Mailing Address - Fax:
Practice Address - Street 1:621 EMBER LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7666
Practice Address - Country:US
Practice Address - Phone:817-929-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist