Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT26143 | FL |
Y | 225100000X | Physical Therapist | PTH6231 | AL |
N | 2251G0304X | Physical Therapist - Geriatrics | PTH6231 | AL |
N | 2251P0200X | Physical Therapist - Pediatrics | PTH6231 | AL |
NPI | 1326607185 |
---|---|
Provider Name | Brannigan Riley Keller |
First Address | Columbus, MS 39705-2024 |
Second Address | Chelsea, AL 35043-4100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2019 |
Last Update Date | 14/08/2019 |