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Individual

MR. KEITH HAUSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
980 LONE RD, PIONEER, TN 37847-4236
(423) 784-4704
(423) 784-1865
Mailing address
PO BOX 541, JELLICO, TN 37762-0541
(423) 784-4704
(423) 784-1865

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000000900
TN
225100000X
Physical Therapist
PT001043
KY

Other

Enumeration date
12/14/2014
Last updated
12/14/2014
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