Individual
KEITH JEROME FREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4054 NW LOOP, CARTHAGE, TX 75633-3346
(903) 693-8504
Mailing address
8325 BLAKE ST, GREENWOOD, LA 71033-3324
(318) 218-0514
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2052140
TX
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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