Provider Demographics
NPI:1689637530
Name:QUIGLEY, KEEGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KEEGAN
Middle Name:
Last Name:QUIGLEY
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 1:215 PLEASANTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2611
Mailing Address - Country:US
Mailing Address - Phone:502-894-8143
Mailing Address - Fax:502-894-8143
Practice Address - Street 1:8211 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5421
Practice Address - Country:US
Practice Address - Phone:502-412-4915
Practice Address - Fax:502-412-4917
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4979111N00000X
CADC28421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor