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NPI Code Detail

MEDICARE: CHRISTOPHER CHARLES KEGLOR L.M.T.

MEDICARE:   CHRISTOPHER CHARLES KEGLOR  L.M.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA41025FL

General Provider Information

NPI Number : 1093995540
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER CHARLES KEGLOR L.M.T.
Provider Business Mailing Address
First Line : 10135 SE 144TH PL
Second Line :
City : SUMMERFIELD
State : FL
Zip : 34491-3725
Country : US
Telephone Number : 352-208-0156
Fax Number :
Provider Business Practice Location Address
First Line : 4820 W NEWBERRY RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32607-2249
Country : US
Telephone Number : 352-373-2116
Fax Number : 352-373-1507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2007
Last Update Date : 11/13/2007

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Directions to “ CHRISTOPHER CHARLES KEGLOR L.M.T.” Practice Location

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