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Individual

AMANDA LYNN KEILY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1839 HEALTH CARE DR STE 1, NEW PORT RICHEY, FL 34655-5363
(727) 372-0812
Mailing address
PO BOX 446, SAFETY HARBOR, FL 34695-0446
(760) 716-0319

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-31297
FL
225100000X
Physical Therapist
PT-4097
ID
225100000X
Physical Therapist
PTL.0013128
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT-0013128
COLORADO DEPARTMENT OF REGULATORY AGENCIES
CO
01
PT-31297
FLORIDA DEPARTMENT OF HEALTH
FL
01
PT-4097
IDAHO DEPT OF HEALTH
ID
Enumeration date
12/04/2017
Last updated
12/04/2017
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