Provider Demographics
NPI:1477802213
Name:RONNA KEAGLE & ASSOCIATES LLC
Entity Type:Organization
Organization Name:RONNA KEAGLE & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-325-1890
Mailing Address - Street 1:9409 BETHANY PLACE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-1227
Mailing Address - Country:US
Mailing Address - Phone:301-325-1890
Mailing Address - Fax:
Practice Address - Street 1:9409 BETHANY PLACE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-1227
Practice Address - Country:US
Practice Address - Phone:301-325-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy