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Individual

CHAD MARVIN KEITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AT, ATC

Contact information

Practice address
915 MICHIGAN ST, SIDNEY, OH 45365-2401
(937) 498-5503
Mailing address
13140 SR 47 W, QUINCY, OH 43343

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
2000019730
OH

Other

Enumeration date
03/21/2018
Last updated
03/21/2018
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