Basic Information
| Provider Information | |||||||||
| NPI: | 1346577335 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEATING | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 VILLAGE OF STONEY RUN APT F | ||||||||
| Address2: | |||||||||
| City: | MAPLE SHADE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080522145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562661374 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2902 ROUTE 130 | ||||||||
| Address2: | |||||||||
| City: | DELRAN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080752525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564618331 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2009 | ||||||||
| LastUpdateDate: | 11/11/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA01335500 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.