Individual
MRS. TEARSA R. KEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810028103
—
WV
Enumeration date
01/26/2011
Last updated
03/01/2016
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