Healthcare Provider Details

I. General information

NPI: 1598720310
Provider Name (Legal Business Name): KECK PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 OLD BARN RD STE C
HENDERSONVILLE NC
28791-8406
US

IV. Provider business mailing address

271 OLD BARN RD STE C
HENDERSONVILLE NC
28791-8406
US

V. Phone/Fax

Practice location:
  • Phone: 828-890-4905
  • Fax: 828-890-8123
Mailing address:
  • Phone: 828-890-4905
  • Fax: 828-890-2371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number7827
License Number StateNC

VIII. Authorized Official

Name: ROBERT ERNEST KECK
Title or Position: PRESIDENT
Credential: MS PT
Phone: 828-890-4905