Provider Demographics
NPI:1073899795
Name:KEY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:KEY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-266-2111
Mailing Address - Street 1:2721 FAIRVIEW BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-9415
Mailing Address - Country:US
Mailing Address - Phone:615-266-2111
Mailing Address - Fax:
Practice Address - Street 1:2721 FAIRVIEW BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-9415
Practice Address - Country:US
Practice Address - Phone:615-266-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3972090Medicare PIN