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General NPI Number Information
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NPI Number | 1699280412
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Entity Type | Individual
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Provider Name | AMANDA LYNN KEILY PT
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Gender | Female
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 12/04/2017
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Provider Practice Location Address
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Address Line | 1839 HEALTH CARE DR STE 1
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-5363
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Country | US
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Telephone | 727-372-0812
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 446
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-0446
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Country | US
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Telephone | 760-716-0319
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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 | PTL.0013128
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-4097
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-31297
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License Number State | FL
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