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1811524945
KEELEY DIANE LANTRIP
FORT WORTH, TX
NPI
1811524945
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA13694)
Enumeration Date
2020-03-26
Last Update Date
2024-03-25
Business Address
KEELEY DIANE LANTRIP
1500 S MAIN ST
FORT WORTH, TX 76104-4941
Phone number: 817-321-0404
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Mailing Address
KEELEY DIANE LANTRIP
816 W CANNON ST
FORT WORTH, TX 76104-3146
Phone number: 817-321-0404
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