Provider Demographics
NPI:1275713323
Name:KEENEY CHIROPRACTIC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KEENEY CHIROPRACTIC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:KEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-353-0337
Mailing Address - Street 1:6200 W. 9TH ST
Mailing Address - Street 2:#2A
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634
Mailing Address - Country:US
Mailing Address - Phone:970-353-0337
Mailing Address - Fax:
Practice Address - Street 1:6200 W. 9TH ST
Practice Address - Street 2:#2A
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634
Practice Address - Country:US
Practice Address - Phone:970-353-0337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty