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NPI Code Detail

MEDICARE: MR. CHRISTOPHER KECK LAC

MEDICARE: MR. CHRISTOPHER KECK LAC
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
1101Y00000XCounselorLAC13926AZ

General Provider Information

NPI Number : 1083033641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER KECK LAC
Provider Business Mailing Address
First Line : 2120 N CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1455
Country : US
Telephone Number : 602-271-4500
Fax Number : 602-282-0102
Provider Business Practice Location Address
First Line : 2120 N CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1455
Country : US
Telephone Number : 602-271-4500
Fax Number : 602-282-0102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2014
Last Update Date : 04/10/2014

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Directions to “ MR. CHRISTOPHER KECK LAC” Practice Location

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