Provider Demographics
NPI:1750458097
Name:KEENER, M. KIRK (DC)
Entity Type:Individual
Prefix:DR
First Name:M.
Middle Name:KIRK
Last Name:KEENER
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 1:335 N RIVER ST
Mailing Address - Street 2:
Mailing Address - City:CENTRE
Mailing Address - State:AL
Mailing Address - Zip Code:35960-1410
Mailing Address - Country:US
Mailing Address - Phone:256-927-7694
Mailing Address - Fax:256-927-7694
Practice Address - Street 1:335 N RIVER ST
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-1410
Practice Address - Country:US
Practice Address - Phone:256-927-7694
Practice Address - Fax:256-927-7694
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor