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General NPI Number Information
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NPI Number | 1659874022
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Entity Type | Individual
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Provider Name | JILL MICHELLE KEEL PT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 13501 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73013-6242
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Country | US
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Telephone | 405-246-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 2808 BERRYWOOD CIR
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City | EDMOND
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State | OK
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Zip | 73034-6831
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Country | US
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Telephone | 405-359-9143
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1814
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License Number State | OK
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