Provider Demographics
NPI:1497138150
Name:JIMMY KEYS FITNESS AND WELLNESS, LLC
Entity Type:Organization
Organization Name:JIMMY KEYS FITNESS AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KEETON
Authorized Official - Suffix:
Authorized Official - Credentials:PLPC
Authorized Official - Phone:314-303-4459
Mailing Address - Street 1:9800 CALUMET DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137-3307
Mailing Address - Country:US
Mailing Address - Phone:314-303-4459
Mailing Address - Fax:
Practice Address - Street 1:9800 CALUMET DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137-3307
Practice Address - Country:US
Practice Address - Phone:314-303-4459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty