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Individual

CHRISTINE KEOGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17577 W DALEA DR, GOODYEAR, AZ 85338-5870
(224) 545-1023
Mailing address
17577 W DALEA DR, GOODYEAR, AZ 85338-5870

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
043.101666
IL
164W00000X
Licensed Practical Nurse
Primary
TLP050903
AZ

Other

Enumeration date
04/20/2015
Last updated
04/20/2015
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