Organization
KEITHLY REHAB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENT ALLEN KEITHLY RPT (PHYSCIAL THERAPIST)
(580) 237-0905
Entity
Organization
Contact information
Practice address
522 W BROADWAY AVE, ENID, OK 73701-3842
(580) 237-0905
(580) 237-0948
Mailing address
522 W BROADWAY AVE, ENID, OK 73701-3842
(580) 237-0905
(580) 237-0948
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3690
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH0005
RAILROAD MEDICARE
OK
Enumeration date
11/06/2005
Last updated
09/22/2008
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