Individual
NANCY KEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 PACKANACK LAKE RD, WAYNE, NJ 07470-5809
(973) 768-6488
Mailing address
21 PACKANACK LAKE RD, WAYNE, NJ 07470-5809
(973) 768-6488
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00024500
NJ
Other
Enumeration date
06/24/2016
Last updated
06/24/2016
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