Provider Demographics
NPI:1609765213
Name:KEOUGH, ALEA MARIE
Entity type:Individual
Prefix:
First Name:ALEA
Middle Name:MARIE
Last Name:KEOUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 SILVERSIDE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1768
Mailing Address - Country:US
Mailing Address - Phone:302-206-6158
Mailing Address - Fax:
Practice Address - Street 1:405 SILVERSIDE RD STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1768
Practice Address - Country:US
Practice Address - Phone:302-206-6158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist