MEDICARE: DR. MICHAEL J KEATING 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
1	111N00000X	Chiropractor	3926	KY

General Provider Information

NPI Number	:	1174525323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J KEATING D.C.

Provider Business Mailing Address
First Line	:	100 JOHN SUTHERLAND DR
Second Line	:	STE 1
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-2424
Country	:	US
Telephone Number	:	859-887-1855
Fax Number	:	859-887-5467

Provider Business Practice Location Address
First Line	:	100 JOHN SUTHERLAND DR
Second Line	:	STE 1
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-2424
Country	:	US
Telephone Number	:	859-887-1855
Fax Number	:	859-887-5467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/08/2007

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