Provider Demographics
NPI:1467700344
Name:LOOP, KEITH M (BA, DSOM, JD, LBMT)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:M
Last Name:LOOP
Suffix:
Gender:M
Credentials:BA, DSOM, JD, LBMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 CHARLOTTE ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1910
Mailing Address - Country:US
Mailing Address - Phone:971-998-0800
Mailing Address - Fax:
Practice Address - Street 1:188 CHARLOTTE ST STE 1A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1910
Practice Address - Country:US
Practice Address - Phone:971-998-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-26
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000873171100000X
CAAC17725171100000X
ORAC180187171100000X
COACU0002336171100000X
VA0019016277225700000X
COMT0000582225700000X
OR17539225700000X
NC19192225700000X
NC2023171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist