Provider Demographics
NPI:1467579698
Name:KEITH PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:KEITH PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-843-5710
Mailing Address - Street 1:13301 N MERIDIAN AVE
Mailing Address - Street 2:BLDG 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9369
Mailing Address - Country:US
Mailing Address - Phone:405-843-5710
Mailing Address - Fax:405-843-5720
Practice Address - Street 1:13301 N MERIDIAN AVE
Practice Address - Street 2:BLDG 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9369
Practice Address - Country:US
Practice Address - Phone:405-843-5710
Practice Address - Fax:405-843-5720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy