Provider Demographics
NPI:1003164369
Name:KEELER, JOSHUA T (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:T
Last Name:KEELER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 S CLINTON AVE STE 435
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5719
Mailing Address - Country:US
Mailing Address - Phone:585-733-3699
Mailing Address - Fax:
Practice Address - Street 1:1815 S CLINTON AVE STE 435
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5719
Practice Address - Country:US
Practice Address - Phone:585-733-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor