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Individual

KIM L KEITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
19424 N R H JOHNSON BLVD, SUN CITY WEST, AZ 85375-1409
(623) 546-4449
(623) 546-4480
Mailing address
6907 E PARADISE LN, SCOTTSDALE, AZ 85254-1577
(623) 546-4449
(623) 546-4480

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1050
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
780917
AZ
Enumeration date
08/05/2006
Last updated
07/08/2007
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