Provider Demographics
NPI:1689927006
Name:KEATING, CHRISTINA (ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 MILL BROOK RD
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-9515
Mailing Address - Country:US
Mailing Address - Phone:802-434-5902
Mailing Address - Fax:
Practice Address - Street 1:70 UPPER MAIN ST
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3168
Practice Address - Country:US
Practice Address - Phone:802-871-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer