Provider Demographics
NPI:1588070825
Name:KEYES, KERRI (PTA)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:KEYES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622-2448
Mailing Address - Country:US
Mailing Address - Phone:585-922-7100
Mailing Address - Fax:585-922-7109
Practice Address - Street 1:1850 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14622-2448
Practice Address - Country:US
Practice Address - Phone:585-922-7100
Practice Address - Fax:585-922-7109
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006231-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant