Provider Demographics
NPI:1770572513
Name:KEEBLE, WILLIAM RITCHIE III (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RITCHIE
Last Name:KEEBLE
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:KEEBLE
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-695-6011
Mailing Address - Fax:325-695-4947
Practice Address - Street 1:1665 ANTILLEY RD
Practice Address - Street 2:SUITE 120
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5265
Practice Address - Country:US
Practice Address - Phone:325-695-6011
Practice Address - Fax:325-695-4947
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1023539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A3281Medicare ID - Type Unspecified
TX8A3281Medicare PIN