Provider Demographics
NPI:1114353075
Name:KEITH, JOSEPH W (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:KEITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:135 BIDARKA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-7741
Mailing Address - Country:US
Mailing Address - Phone:907-283-3752
Mailing Address - Fax:907-283-3792
Practice Address - Street 1:135 BIDARKA ST
Practice Address - Street 2:SUITE B
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7741
Practice Address - Country:US
Practice Address - Phone:907-283-3752
Practice Address - Fax:907-283-3792
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2016-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor