Provider Demographics
NPI:1396326872
Name:KEIL, KARLY (DPT)
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:KEIL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 FERNWOOD RD STE 506
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1184
Mailing Address - Country:US
Mailing Address - Phone:301-530-1010
Mailing Address - Fax:
Practice Address - Street 1:1635 N GEORGE MASON DR STE 180
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205
Practice Address - Country:US
Practice Address - Phone:301-530-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407069225100000X
MD28820225100000X
VA2305214949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist