Individual
KEITH BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1166 W 7TH AVE, EUGENE, OR 97402-4616
(458) 210-2940
(541) 654-4680
Mailing address
1166 W 7TH AVE, EUGENE, OR 97402-4616
(458) 210-2940
(541) 654-4680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3956
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3956
LICENSE
OR
Enumeration date
05/30/2012
Last updated
01/17/2025
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