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Individual
KEELY O'DELL
Active
Individual
KEELY O'DELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT022775
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178507721
—
AR
Enumeration date
10/06/2009
Last updated
10/16/2013
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