Provider Demographics
NPI:1083587000
Name:KEITH CLINIC ESTRAMONTE CHIROPRACTIC KINGS MOUNTAIN PA
Entity type:Organization
Organization Name:KEITH CLINIC ESTRAMONTE CHIROPRACTIC KINGS MOUNTAIN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCOUNTING ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-420-4690
Mailing Address - Street 1:510A W KING ST
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-3310
Mailing Address - Country:US
Mailing Address - Phone:980-396-2811
Mailing Address - Fax:
Practice Address - Street 1:510A W KING ST
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3310
Practice Address - Country:US
Practice Address - Phone:980-396-2811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty