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Individual

KEATON LEE MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
428 N 6TH ST, TOMAHAWK, WI 54487-1425
(877) 230-3885
Mailing address
800 NE COLLEEN DR, LEES SUMMIT, MO 64086-4916

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2017026960
MO

Other

Enumeration date
08/04/2017
Last updated
08/04/2017
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