Provider Demographics
NPI:1972761542
Name:KEITH, ROBYN CHARLENE (PT)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:CHARLENE
Last Name:KEITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:CHALLINGSWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1784 GALUSHA RD
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15824-6710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 S 8TH ST
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2811
Practice Address - Country:US
Practice Address - Phone:814-375-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist