Provider Demographics
NPI:1902195050
Name:KEEFER CHIROPRACTIC CENTER, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KEEFER CHIROPRACTIC CENTER, A PROFESSIONAL CORPORATION
Other - Org Name:KEEFER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-333-9723
Mailing Address - Street 1:521 YOPP RD, STE 214 PMB 308
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540
Mailing Address - Country:US
Mailing Address - Phone:910-333-9723
Mailing Address - Fax:
Practice Address - Street 1:521 YOPP RD STE 107
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-3597
Practice Address - Country:US
Practice Address - Phone:910-333-9723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty