Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist |
NPI | 1013155704 |
---|---|
Provider Name | Thomas Patrick O'keefe |
First Address | Minneapolis, MN 55417-2309 |
Second Address | Minneapolis, MN 55417-2309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 03/02/2009 |