Provider Demographics
NPI:1215026596
Name:KEELER CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:KEELER CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:KEELER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-662-6607
Mailing Address - Street 1:1700 E 30TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1263
Mailing Address - Country:US
Mailing Address - Phone:785-483-4909
Mailing Address - Fax:785-483-5166
Practice Address - Street 1:1700 E 30TH AVE STE A
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1263
Practice Address - Country:US
Practice Address - Phone:620-662-6607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1093784787OtherINDIVIDUAL NPI #
KS062050OtherBLUE CROSS BLUE SHIELD
KSU50265Medicare UPIN
KS660061Medicare ID - Type Unspecified