Provider Demographics
NPI:1780950600
Name:KEEGAN, SHAWN A (PT)
Entity type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:A
Last Name:KEEGAN
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 1:5169 SUGAR CAMP RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-9674
Mailing Address - Country:US
Mailing Address - Phone:513-831-9186
Mailing Address - Fax:
Practice Address - Street 1:5169 SUGAR CAMP RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-9674
Practice Address - Country:US
Practice Address - Phone:513-831-9186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT004706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist