Provider Demographics
NPI:1417978693
Name:KEENUM, BARBARA A (PT)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:KEENUM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35653-0626
Mailing Address - Country:US
Mailing Address - Phone:562-332-6208
Mailing Address - Fax:562-332-6213
Practice Address - Street 1:101 JAMES HOVATER RD
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35653-8004
Practice Address - Country:US
Practice Address - Phone:256-332-6208
Practice Address - Fax:256-332-6213
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL890013860Medicaid
AL510-01596OtherBCBS
AL890013860Medicaid