Provider Demographics
NPI:1033313226
Name:MESSAMORE, KEITH C (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:C
Last Name:MESSAMORE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1234 N EAGLE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8429
Mailing Address - Country:US
Mailing Address - Phone:269-353-3606
Mailing Address - Fax:269-353-3606
Practice Address - Street 1:5053 SPORTS DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-7117
Practice Address - Country:US
Practice Address - Phone:269-978-4325
Practice Address - Fax:269-978-1108
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKM008130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor