Provider Demographics
NPI:1326125808
Name:VINSON, KEELY NACOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:KEELY
Middle Name:NACOLE
Last Name:VINSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5760 CARMICHAEL PKWY STE 8
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2333
Mailing Address - Country:US
Mailing Address - Phone:334-274-0013
Mailing Address - Fax:334-277-2919
Practice Address - Street 1:5760 CARMICHAEL PKWY STE 8
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2333
Practice Address - Country:US
Practice Address - Phone:334-274-0013
Practice Address - Fax:334-277-2919
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1960111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor