Provider Demographics
NPI:1376799411
Name:O'KEEFE, HOLLY MARIE (PT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8097 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2321
Mailing Address - Country:US
Mailing Address - Phone:513-931-5000
Mailing Address - Fax:513-931-2709
Practice Address - Street 1:8097 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2321
Practice Address - Country:US
Practice Address - Phone:513-931-5000
Practice Address - Fax:513-931-2709
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005863225100000X
OH10055225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0053933Medicaid
KYP00983521Medicare PIN
OH0053933Medicaid
OHH020760Medicare PIN