Provider Demographics
NPI:1437758166
Name:O'KEEFE, LAURYN (DPT)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:
Last Name:O'KEEFE
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 1:415 NEPONSET AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3168
Mailing Address - Country:US
Mailing Address - Phone:774-218-5585
Mailing Address - Fax:
Practice Address - Street 1:101 PLEASANT ST STE 114
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-3213
Practice Address - Country:US
Practice Address - Phone:508-798-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist