Individual
MOLLY FITZGERALD KEOGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9801 FRONTIER AVE SE, SNOQUALMIE, WA 98065-5200
(425) 831-2321
(425) 831-2361
Mailing address
9801 FRONTIER AVENUE SE, SNOQUALMIE, WA 98065
(425) 831-2321
(425) 831-2361
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1 60338751
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P1 60338751
PTA LICENSE
WA
Enumeration date
06/17/2014
Last updated
06/17/2014
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