Provider Demographics
NPI:1487006516
Name:FOLEY, KEITH (PT)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:FOLEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:KEITH
Other - Middle Name:
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:479 WASHINGTON ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5895
Mailing Address - Country:US
Mailing Address - Phone:617-563-1161
Mailing Address - Fax:
Practice Address - Street 1:479 WASHINGTON ST UNIT 5
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5895
Practice Address - Country:US
Practice Address - Phone:617-563-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic