NPI 1255562294

Michael D Keown, COLPO

Practitioner Prosthetist Tyler, TX

Practice location

Address: 2413 E 5th St, Tyler, TX 75701-3523
Phone: (903) 533-8202
Fax: (903) 533-8611

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence 1373 (TX)

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X Licence 1373 (TX)

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Registry record

NPI: 1255562294
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Aug 2009
Record last updated: 6 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.