Keough Chiropractic, Inc in Grand Terrace - Chiropractor
Keough Chiropractic, Inc - NPI 1104026913
Keough Chiropractic, Inc is a Chiropractor in Grand Terrace, California. Keough Chiropractic, Inc practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Keough Chiropractic, Inc is 1104026913. The last update date is 2008-10-31.
Keough Chiropractic, Inc's current location address is 12139 Mount Vernon Ave Ste 100, Grand Terrace, California. You can contact this provider via phone number 9097834950 and fax number 9097831008. The mailing address for Keough Chiropractic, Inc is 12139 Mount Vernon Ave Ste 100, Grand Terrace, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Keough Chiropractic, Inc |
|---|---|
| Address | 12139 Mount Vernon Ave Ste 100, Grand Terrace, California |
| Phone Number | 9097834950 |
| Fax Number | 9097831008 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Keough Patrick Kelly |
| Credentials | DC |
| Telephone Number | 9097834950 |
NPI Number Detail
| NPI Number | 1104026913 |
|---|---|
| Provider Enumeration Date | 2007-07-19 |
| Last Updated Date | 2008-10-31 |
Provider Mailing Address Detail
| Address | 12139 Mount Vernon Ave Ste 100 |
|---|---|
| City | Grand Terrace |
| State | California (CA) |
| Post Code | 923135519 |
| Phone Number | 9097834950 |
| Fax Number | 9097831008 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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What is the unique 10-digit identifier code issued to Keough Chiropractic, Inc by the Centers for Medicare & Medicaid Services?
The Keough Chiropractic, Inc has been assigned the NPI (National Provider Identifier) 1104026913 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Keough Chiropractic, Inc's physical address?
The Keough Chiropractic, Inc is physically located at 12139 Mount Vernon Ave Ste 100, in the city of Grand Terrace, CA, with the postal code 923135519.
What is Keough Chiropractic, Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Keough Chiropractic, Inc's area of specialization is Chiropractor, and the corresponding taxonomy code that categorizes this field of practice is 111N00000X.
On what date did the Keough Chiropractic, Inc receive the assignment of its 1104026913 from the Centers for Medicare & Medicaid Services?
The Keough Chiropractic, Inc was issued its 1104026913 by the Centers for Medicare & Medicaid Services on 2007-07-19.
As of what date were the Keough Chiropractic, Inc's details last updated?
The information pertaining to the Keough Chiropractic, Inc, including its address, specialty, and other details, was most recently updated on 2008-10-31.
NPI Number: 1417950320
Address: 1395 Center Drive, D7-6a, Box 100416, Gainesville, FL