Provider Demographics
NPI:1205249737
Name:KEENAN, ALANNA (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
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 1:2470 IVORY ANN DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-9188
Mailing Address - Country:US
Mailing Address - Phone:530-906-7689
Mailing Address - Fax:530-906-7689
Practice Address - Street 1:2470 IVORY ANN DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-9188
Practice Address - Country:US
Practice Address - Phone:530-906-7689
Practice Address - Fax:530-906-7689
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist