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General NPI Number Information
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NPI Number | 1962857508
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Entity Type | Individual
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Provider Name | KEISHA HAY
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 208 PENNKNOLL RD
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City | EVERETT
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State | PA
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Zip | 15537-6940
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Country | US
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Telephone | 814-623-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 MAIN ST
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City | BERLIN
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State | PA
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Zip | 15530-1438
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | TE010922
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License Number State | PA
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