Individual
MITZI KEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1 SUTPHIN DR, MARMET, WV 25315-1977
(304) 949-1580
Mailing address
1 SUTPHIN DR, MARMET, WV 25315-1977
(304) 949-1580
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1333
WV
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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