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General NPI Number Information
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NPI Number | 1609388743
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Entity Type | Individual
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Provider Name | KEEGAN MURPHY WARNER
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Gender | Female
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 2200 N SQUIRREL RD RM 116
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City | ROCHESTER
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State | MI
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Zip | 48309-4402
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Country | US
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Telephone | 248-370-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 304 W DUNLAP ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1405
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2601001342
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License Number State | MI
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