Provider Demographics
NPI:1730567975
Name:KEITH, KATELYN (DPT)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:KEITH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:2442 TONGASS AVE
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5928
Mailing Address - Country:US
Mailing Address - Phone:907-225-7808
Mailing Address - Fax:907-247-7868
Practice Address - Street 1:1755 WITTINGTON PL
Practice Address - Street 2:SUITE #175
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-1927
Practice Address - Country:US
Practice Address - Phone:866-221-5405
Practice Address - Fax:866-534-5697
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist