Individual
DR. KEITH ALAN SHAULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5440 E SOUTHERN AVE, SUITE 101, MESA, AZ 85206-2779
(480) 641-3533
Mailing address
11421 E PALOMA AVE, MESA, AZ 85212-1971
(480) 813-0349
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7213
AZ
Other
Enumeration date
07/03/2006
Last updated
01/28/2014
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