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Individual

MARY KEOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
445 SAINT PAUL ST, NORTH SMITHFIELD, RI 02896-6865
(401) 597-5665
Mailing address
47 HILLTOP AVE, PROVIDENCE, RI 02908-2810
(401) 316-8344

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PT03193
RI

Other

Enumeration date
08/15/2019
Last updated
08/15/2019
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