Healthcare Provider Details
I. General information
NPI: 1316475767
Provider Name (Legal Business Name): AUSTIN LOUIS KEYS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/30/2017
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3915 E EXPOSITION AVE STE 100
DENVER CO
80209-5052
US
IV. Provider business mailing address
8786 W INDORE DR
LITTLETON CO
80128-4242
US
V. Phone/Fax
- Phone: 303-955-4609
- Fax: 720-484-6377
- Phone: 715-495-0032
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 2786668 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 0007618 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: