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General NPI Number Information
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NPI Number | 1447170105
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Entity Type | Individual
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Provider Name | TINA RENEE KEIS
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Gender | Female
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 900 W DOLPHIN ST
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City | SILER CITY
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State | NC
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Zip | 27344-3711
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Country | US
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Telephone | 919-663-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 133 WINNIPEG RD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3935
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Country | US
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Telephone | 706-836-9740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | NC
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