Provider Demographics
NPI:1932939220
Name:KEESEE, JAMES AUSTIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:AUSTIN
Last Name:KEESEE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10630 CLEARPOINT DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-3102
Mailing Address - Country:US
Mailing Address - Phone:804-971-6404
Mailing Address - Fax:
Practice Address - Street 1:6800 WOODLAKE COMMONS LOOP
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2281
Practice Address - Country:US
Practice Address - Phone:804-302-4589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist