Provider Demographics
NPI:1275098527
Name:KERAN, CALEB ELIJAH (DC)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:ELIJAH
Last Name:KERAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 INDIAN ACRES CT
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-1619
Mailing Address - Country:US
Mailing Address - Phone:770-570-0796
Mailing Address - Fax:
Practice Address - Street 1:2347 BROCKETT RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4474
Practice Address - Country:US
Practice Address - Phone:770-938-4606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO20251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor