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Individual

MR. LEE KEASAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
2014 BALTIMORE REYNOLDSBURG RD, REYNOLDSBURG, OH 43068-3261
(614) 522-6900
Mailing address
335 GLESSNER AVE RM 325, MANSFIELD, OH 44903-2269
(419) 520-2495

Taxonomy

Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
COA.15993-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0174849
OH
Enumeration date
06/23/2014
Last updated
12/15/2021
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