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Individual
BRIDGET KEOUGH KEOUGH
Active
Individual
BRIDGET KEOUGH KEOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00234000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MT00234000
BOARD OF MEDICAL EXAMINERS
NJ
Enumeration date
05/03/2020
Last updated
05/03/2020
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