Provider Demographics
NPI:1568129120
Name:KEENAN, JOSHUA JAVIER (DPT)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JAVIER
Last Name:KEENAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15746 JACKSON CREEK PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-7183
Mailing Address - Country:US
Mailing Address - Phone:719-481-0899
Mailing Address - Fax:719-481-0897
Practice Address - Street 1:15746 JACKSON CREEK PKWY STE B
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-7183
Practice Address - Country:US
Practice Address - Phone:719-481-0899
Practice Address - Fax:719-481-0897
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19796225100000X
FLPT38077225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist