Keith Deagostine

NPI #1649508755 in West Point, Utah

Provider Information

NPI Number: 1649508755
Entity Type: Individual
Name: Keith Deagostine
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Dec 1, 2009
Last Updated: Sep 12, 2011

Practice Location

Address: 3072 W 300 N
Address 2: SUITE A
City: West Point
State: Utah
ZIP Code: 84015-3933
Phone: (914) 623-8375

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary
Clinic/Center - Physical Therapy — Physical Therapy	261QP2000X

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