Provider Demographics
NPI:1871528695
Name:MCKEEVER, BRIAN KEITH (MPT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:KEITH
Last Name:MCKEEVER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MILITARY CUTOFF RD STE A1
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-8303
Mailing Address - Country:US
Mailing Address - Phone:910-805-1111
Mailing Address - Fax:910-777-9508
Practice Address - Street 1:330 MILITARY CUTOFF RD STE A1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-8303
Practice Address - Country:US
Practice Address - Phone:910-805-1111
Practice Address - Fax:910-777-9508
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19647225100000X
NCP12157225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT196470Medicare ID - Type UnspecifiedPHYSICAL THERAPY