Provider Demographics
NPI:1881003044
Name:SAYBALL, KEITH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:SAYBALL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 OSSIPEE TRL E
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:ME
Mailing Address - Zip Code:04084-6464
Mailing Address - Country:US
Mailing Address - Phone:207-642-5325
Mailing Address - Fax:207-642-5395
Practice Address - Street 1:9 ETHAN ALLEN HWY
Practice Address - Street 2:2 NORTH AND SOUTH
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877
Practice Address - Country:US
Practice Address - Phone:203-493-5056
Practice Address - Fax:207-493-5078
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT4265225100000X
CT11817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist