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1265130728
KEANE EVANGELISTA
LA MESA, CA
NPI
1265130728
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2023-02-23
Last Update Date
2023-02-23
Business Address
KEANE EVANGELISTA
5696 LAKE MURRAY BLVD
LA MESA, CA 91942-1929
Phone number: 619-460-7871
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Mailing Address
KEANE EVANGELISTA
7548 CHARMANT DR APT 1411
SAN DIEGO, CA 92122-5050
Phone number:
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