Provider Demographics
NPI:1871201467
Name:GASKINS, KESHIA LYN (PTA)
Entity type:Individual
Prefix:
First Name:KESHIA
Middle Name:LYN
Last Name:GASKINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:KESHIA
Other - Middle Name:LYN
Other - Last Name:SCHOENADEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:83 SILL DR
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-7551
Mailing Address - Country:US
Mailing Address - Phone:304-820-9152
Mailing Address - Fax:
Practice Address - Street 1:108 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401
Practice Address - Country:US
Practice Address - Phone:304-263-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306604267225200000X
WV002152225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant