Provider Demographics
NPI:1710088869
Name:TIMOTHY J KEYES JR., DC LLC
Entity Type:Organization
Organization Name:TIMOTHY J KEYES JR., DC LLC
Other - Org Name:CLEVELAND SPINE AND PERFORMANCE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:KEYES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:440-684-1000
Mailing Address - Street 1:5122 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2406
Mailing Address - Country:US
Mailing Address - Phone:440-684-1000
Mailing Address - Fax:
Practice Address - Street 1:5122 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2406
Practice Address - Country:US
Practice Address - Phone:440-684-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3639261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service