Individual
KEATON SHEAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
685 CITADEL DR E STE 125, COLORADO SPRINGS, CO 80909-5316
(719) 275-7650
Mailing address
410 W 28TH ST, PUEBLO, CO 81003-3632
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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