Keith Tisdell

NPI #1477550630 in Kyle, Texas

Provider Information

NPI Number: 1477550630
Entity Type: Individual
Name: Keith Tisdell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: Jul 3, 2005
Last Updated: Jan 11, 2012

Practice Location

Address: 189 DECKER
City: Kyle
State: Texas
ZIP Code: 78640-5791
Phone: (954) 328-5436

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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