Individual
DR. KEITH W. HALLBOURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
68A HEALD ST, PEPPERELL, MA 01463-1248
(603) 305-6452
Mailing address
68A HEALD ST, PEPPERELL, MA 01463-1248
(603) 305-6452
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13106
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13106
LICENSE
MA
Enumeration date
04/03/2008
Last updated
04/03/2008
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