Provider Demographics
NPI:1821440710
Name:KEITH, MANPREET (DC)
Entity Type:Individual
Prefix:
First Name:MANPREET
Middle Name:
Last Name:KEITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 EASTERN AVE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3061
Mailing Address - Country:US
Mailing Address - Phone:443-842-5500
Mailing Address - Fax:443-842-5501
Practice Address - Street 1:2001 EASTERN AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3061
Practice Address - Country:US
Practice Address - Phone:443-842-5500
Practice Address - Fax:443-842-5501
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor