Provider Demographics
NPI:1730411265
Name:KRISTIN KEENAN, P.T.
Entity type:Organization
Organization Name:KRISTIN KEENAN, P.T.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:774-230-1059
Mailing Address - Street 1:34 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:NEWFIELDS
Mailing Address - State:NH
Mailing Address - Zip Code:03856-8235
Mailing Address - Country:US
Mailing Address - Phone:774-230-1059
Mailing Address - Fax:603-836-4632
Practice Address - Street 1:34 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:NEWFIELDS
Practice Address - State:NH
Practice Address - Zip Code:03856-8235
Practice Address - Country:US
Practice Address - Phone:774-230-1059
Practice Address - Fax:603-836-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3207261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy