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1619024361
KEITH SHAW
SALEM, IL
NPI
1619024361
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: IL 070006534)
Enumeration Date
2007-01-04
Last Update Date
2007-07-08
Business Address
-- KEITH SHAW PT
1250 W WHITTAKER ST
SALEM, IL 62881-1917
Phone number: 618-548-3769
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Mailing Address
-- KEITH SHAW PT
PO BOX 503861
SAINT LOUIS, MO 63150-0001
Phone number: 618-548-3769
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