Healthcare Provider Details

I. General information

NPI: 1508996190
Provider Name (Legal Business Name): BARBARA ANN AUG KEEFE D.P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 CHANDLER DR
SPOONER WI
54801-2202
US

IV. Provider business mailing address

N3528 CALDWELL RD
SHELL LAKE WI
54871-8788
US

V. Phone/Fax

Practice location:
  • Phone: 715-635-2111
  • Fax: 715-939-1557
Mailing address:
  • Phone: 715-645-2198
  • Fax: 715-939-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4364024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: