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NPI Code Detail

MEDICARE: DR. JASON LEE KELLER D.C.

MEDICARE: DR. JASON LEE KELLER D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHR-5184CO

General Provider Information

NPI Number : 1033389481
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON LEE KELLER D.C.
Provider Business Mailing Address
First Line : 4440 BARNES RD
Second Line : SUITE 200
City : COLORADO SPRINGS
State : CO
Zip : 80917-1564
Country : US
Telephone Number : 719-597-7206
Fax Number : 719-597-7864
Provider Business Practice Location Address
First Line : 4440 BARNES RD
Second Line : SUITE 200
City : COLORADO SPRINGS
State : CO
Zip : 80917-1564
Country : US
Telephone Number : 719-597-7206
Fax Number : 719-597-7864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2008
Last Update Date : 02/29/2008

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