Provider Demographics
NPI:1831226588
Name:KEEFE, MAUREEN (MOLLY) ANN (DC)
Entity type:Individual
Prefix:DR
First Name:MAUREEN (MOLLY)
Middle Name:ANN
Last Name:KEEFE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-1551
Mailing Address - Country:US
Mailing Address - Phone:802-527-2225
Mailing Address - Fax:802-527-2013
Practice Address - Street 1:128 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-1551
Practice Address - Country:US
Practice Address - Phone:802-527-2225
Practice Address - Fax:802-527-2013
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT982111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVN1419Medicaid
VTVN1419Medicare ID - Type Unspecified