Provider Demographics
NPI:1568971471
Name:PERRY, KEETON (DC)
Entity Type:Individual
Prefix:DR
First Name:KEETON
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3964 STATE HIGHWAY 121 APT 3096
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-8600
Mailing Address - Country:US
Mailing Address - Phone:903-240-1120
Mailing Address - Fax:
Practice Address - Street 1:2800 N INTERSTATE 35E STE 200
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-4405
Practice Address - Country:US
Practice Address - Phone:214-995-8299
Practice Address - Fax:972-920-3468
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor