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NPI Code Detail

MEDICARE: KERI MAST

MEDICARE: KERI MAST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305202865VA

General Provider Information

NPI Number : 1154652832
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERI MAST
Provider Business Mailing Address
First Line : 10186 WOODLANDS CHURCH RD
Second Line :
City : LINVILLE
State : VA
Zip : 22834-2233
Country : US
Telephone Number : 540-833-8187
Fax Number :
Provider Business Practice Location Address
First Line : 1481 VIRGINIA AVE
Second Line :
City : HARRISONBURG
State : VA
Zip : 22802-2433
Country : US
Telephone Number : 540-438-4228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2010
Last Update Date : 01/20/2010

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Directions to “ KERI MAST ” Practice Location

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