Provider Demographics
NPI:1801022215
Name:MASSI, KEITH ANTHONY (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ANTHONY
Last Name:MASSI
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 DELTONA BLVD
Mailing Address - Street 2:SUITE 12 AND 13
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-8012
Mailing Address - Country:US
Mailing Address - Phone:407-538-2233
Mailing Address - Fax:
Practice Address - Street 1:577 DELTONA BLVD
Practice Address - Street 2:SUITE 12 AND 13
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8012
Practice Address - Country:US
Practice Address - Phone:407-538-2233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor