Provider Demographics
NPI:1982632873
Name:CONOVER, KEITH V (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:V
Last Name:CONOVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4276 MAPLE ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1040
Mailing Address - Country:US
Mailing Address - Phone:716-831-0011
Mailing Address - Fax:716-831-0012
Practice Address - Street 1:4276 MAPLE ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1040
Practice Address - Country:US
Practice Address - Phone:716-831-0011
Practice Address - Fax:716-831-0012
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005754111N00000X
NYX005754-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8809939OtherINDEPENDENT HEALTH
NY16156789901OtherPRISM
NY8809939OtherINDEPENDENT HEALTH