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Individual

KEITH MUSHINSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2600 GLASGOW AVE, SUITE 105, NEWARK, DE 19702-4773
(302) 838-2165
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0002255
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11797340
CAQH
01
1265634471
CHAMPUS TRICARE
05
1265634471
DE
01
2872480000
IBC AMERIHEALTH
Enumeration date
06/01/2007
Last updated
03/22/2013
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