Individual
MELISSA KEIGHTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5118 NE 26TH AVE, PORTLAND, OR 97211-6325
(954) 328-9769
Mailing address
5118 NE 26TH AVE, PORTLAND, OR 97211-6325
(954) 328-9769
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62128
OR
Other
Enumeration date
03/26/2017
Last updated
03/26/2017
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