Search › Illinois › 103K00000X

Keith Driscoll, P.HD

NPI 1073899621 · on the registry since 2011 · sole proprietor

Practice

Address
1207 S Elm St
Centralia, IL 62801
Phone
(618) 579-9072

Additional practice sites

  • 904 E. Martin Luther King Drive, Centralia, IL
  • 140 N Locust St, Centralia, IL
  • 1207 S Elm St, Centralia, IL

Registry record

Primary taxonomy
103K00000X
103K00000X
Licence states on file
WA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-11-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois