Provider Demographics
NPI:1659480267
Name:KEYS, ROSS CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:CHRISTOPHER
Last Name:KEYS
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 1:1288 SW SIMPSON AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3195
Mailing Address - Country:US
Mailing Address - Phone:541-617-9969
Mailing Address - Fax:541-617-9890
Practice Address - Street 1:1288 SW SIMPSON AVE
Practice Address - Street 2:SUITE K
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3195
Practice Address - Country:US
Practice Address - Phone:541-617-9969
Practice Address - Fax:541-617-9890
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORJ3403-01OtherPACIFIC SOURCE - CHIRO
ORP00307145OtherPALMETO - GBA
ORJ3403-01OtherPACIFIC SOURCE - CHIRO
OR131281Medicare ID - Type UnspecifiedGROUP MEDICARE
ORP00307145OtherPALMETO - GBA