Provider Demographics
NPI:1205122488
Name:KEELING, KATHRYN (KATE) GLADYS (EBERT) (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN (KATE)
Middle Name:GLADYS (EBERT)
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 1:5911 E GELDING DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5515
Mailing Address - Country:US
Mailing Address - Phone:602-867-3637
Mailing Address - Fax:602-996-4903
Practice Address - Street 1:5911 E GELDING DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5515
Practice Address - Country:US
Practice Address - Phone:602-867-3637
Practice Address - Fax:602-996-4903
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist