Provider Demographics
NPI:1932282233
Name:KETTERING GROUP INC.
Entity Type:Organization
Organization Name:KETTERING GROUP INC.
Other - Org Name:KETTERING CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KETTERING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-290-7177
Mailing Address - Street 1:1601 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4528
Mailing Address - Country:US
Mailing Address - Phone:717-290-7177
Mailing Address - Fax:717-290-1148
Practice Address - Street 1:1601 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4528
Practice Address - Country:US
Practice Address - Phone:717-290-7177
Practice Address - Fax:717-290-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 001950L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKE094104Medicare ID - Type Unspecified