Provider Demographics
NPI:1861503310
Name:LINDON W KEELER DC INC PS
Entity Type:Organization
Organization Name:LINDON W KEELER DC INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDON
Authorized Official - Middle Name:WOOD
Authorized Official - Last Name:KEELER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-715-9010
Mailing Address - Street 1:2406 IRON ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3819
Mailing Address - Country:US
Mailing Address - Phone:360-715-9010
Mailing Address - Fax:360-715-9005
Practice Address - Street 1:2406 IRON ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3819
Practice Address - Country:US
Practice Address - Phone:360-715-9010
Practice Address - Fax:360-715-9005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINDON W KEELER DC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH2685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U34845Medicare UPIN
WA001400340Medicare ID - Type Unspecified