Individual
KEEGAN KIMMINAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5345 MARIAN LN, VIRGINIA BEACH, VA 23462-1841
(757) 456-5018
Mailing address
222 TIMBER VALLEY DR, LINN VALLEY, KS 66040-5396
(913) 244-1690
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-07283
KS
225100000X
Physical Therapist
CP031999T
VA
Other
Enumeration date
07/17/2023
Last updated
06/24/2024
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