Provider Demographics
NPI:1295771566
Name:KEEGAN, KAREN L (PT, MDT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:KEEGAN
Suffix:
Gender:F
Credentials:PT, MDT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:SEEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:836 HOUSTON RUN DR STE 101
Practice Address - Street 2:
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9496
Practice Address - Country:US
Practice Address - Phone:717-442-8957
Practice Address - Fax:717-442-1063
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10000932225100000X
PAPT007844L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
292883OtherMAMSI
2279316000OtherAMERIHEALTH IBC
5070-0035OtherCAREFIRST/FEDERAL
DE1000037856Medicaid
DEJ10000932OtherDE LICENSE
PA1600643OtherPA BS
5070-0035OtherCARE FIRST
620720-01OtherCAREFIRST/NCA
62072001OtherNCA
P00398574OtherRR MEDICARE
5070-0035OtherCAREFIRST/FEDERAL
DE1000037856Medicaid
620720-01OtherCAREFIRST/NCA