Individual
DR. BROOKS RYAN KEESHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-3606
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 703-6204
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35095704
OH
208000000X
Pediatrics Physician
63590491205
UT
2084P0804X
Child & Adolescent Psychiatry Physician
35095704
OH
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
63590491205
UT
Other
Enumeration date
10/04/2007
Last updated
11/03/2021
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