Keith Kirimi Ndege

Individual provider Active NPI Physical Therapy Assistant · Fargo, ND

NPI 1780247023 · NPPES record last updated Apr 22, 2019

Key facts

NPI
1780247023
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA.0014512 (CO)
Practice address
5225 23Rd Ave South
Fargo, ND 58104
Phone
(701) 417-3400
NPI assigned
Apr 22, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA.0014512COMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA.0014512 CO Yes

Addresses

Primary practice location

5225 23Rd Ave South
Fargo, ND 58104

Mailing address

5357 27TH St South, Apt 110
Fargo, ND 58104
Phone (701) 781-7573

Other providers in Fargo, ND

All providers in Fargo, ND · Physical Therapy Assistant in North Dakota

Sources for this page

Verify at the official NPI Registry.