KEITH SHAW

SALEM, IL
NPI1619024361
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: IL  070006534)
Enumeration Date2007-01-04
Last Update Date2007-07-08
Business Address
-- KEITH SHAW PT
1250 W WHITTAKER ST
SALEM, IL 62881-1917
Phone number: 618-548-3769
Mailing Address
-- KEITH SHAW PT
PO BOX 503861
SAINT LOUIS, MO 63150-0001
Phone number: 618-548-3769
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