Provider Demographics
NPI:1346495777
Name:DR. KEITH GRAVES DC, INC
Entity Type:Organization
Organization Name:DR. KEITH GRAVES DC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-756-0360
Mailing Address - Street 1:1776 S JACKSON ST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3801
Mailing Address - Country:US
Mailing Address - Phone:303-756-0360
Mailing Address - Fax:303-484-2860
Practice Address - Street 1:1776 S JACKSON ST
Practice Address - Street 2:SUITE 1005
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3801
Practice Address - Country:US
Practice Address - Phone:303-756-0360
Practice Address - Fax:303-484-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty