Provider Demographics
NPI:1013999192
Name:KEELING, KATHLEEN ALANE (PT)
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:ALANE
Last Name:KEELING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 CRINELLA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1007
Mailing Address - Country:US
Mailing Address - Phone:707-967-8641
Mailing Address - Fax:
Practice Address - Street 1:206 BON AIR SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2416
Practice Address - Country:US
Practice Address - Phone:415-927-4040
Practice Address - Fax:415-925-1250
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist