Provider Demographics
NPI:1073756086
Name:JEANETTE Y KELDER DC PC
Entity Type:Organization
Organization Name:JEANETTE Y KELDER DC PC
Other - Org Name:THE WELLNESS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KELDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-424-0401
Mailing Address - Street 1:7615 W 38TH AVE
Mailing Address - Street 2:SUITE B-107
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6172
Mailing Address - Country:US
Mailing Address - Phone:303-424-0401
Mailing Address - Fax:
Practice Address - Street 1:7615 W 38TH AVE
Practice Address - Street 2:SUITE B-107
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6172
Practice Address - Country:US
Practice Address - Phone:303-424-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC516688Medicare PIN