Keck, Krista Lee

Keck, Krista Lee is an individual health care provider with primary practice located at 10560 Applewood Dr , Sister Bay WI 54234-9005. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Keck, Krista Lee can be contacted via phone (920) 854-4111.

Contact Information

Primary practice address
10560 Applewood Dr Sister Bay WI 54234-9005
Phone: (920) 854-4111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 12522-24 Wisconsin

Profile Details

NPI number 1164575791
LBN Legal business name Keck, Krista Lee
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Feb 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164575791 NPPES
Wisconsin MEDICAID 1164575791

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