Individual
MISTY D KEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
502 DOVE CREEK DR, ROUND ROCK, TX 78664-5920
(512) 743-6010
Mailing address
502 DOVE CREEK DR, ROUND ROCK, TX 78664-5920
(512) 743-6010
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
MT107484
TX
225700000X
Massage Therapist
Primary
MT107484
TX
332BC3200X
Customized Equipment (DME)
MT107484
TX
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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