Individual
AMY DIANE KEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
811 W. 8TH STREET, DEWAR, OK 74431
(918) 407-2857
Mailing address
P.O. BOX 1051, DEWAR, OK 74431
(918) 407-2857
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
863
OK
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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