Provider Demographics
NPI:1073634440
Name:WHITE-KEON, DINA J (DC)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:J
Last Name:WHITE-KEON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 FULTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7396
Mailing Address - Country:US
Mailing Address - Phone:916-487-3007
Mailing Address - Fax:916-487-1197
Practice Address - Street 1:1260 FULTON AVE STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7396
Practice Address - Country:US
Practice Address - Phone:916-487-3007
Practice Address - Fax:916-487-1197
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor