Individual
DR. KEITH LOUIS PADDOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2104 NORTHDALE BLVD NW, COON RAPIDS, MN 55433-3005
(763) 755-5495
Mailing address
3327 ARCADE ST S, VADNAIS HEIGHTS, MN 55127-5002
(651) 765-1764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7457
MN
Other
Enumeration date
03/15/2006
Last updated
07/08/2007
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