Individual
KEITH EVAN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 GOULD AVE, 42, MEREDITH, NH 03253-6539
(603) 289-0779
Mailing address
23 GOULD AVE, 42, MEREDITH, NH 03253-6539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1025
NH
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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