Healthcare Provider Details

I. General information

NPI: 1043480114
Provider Name (Legal Business Name): RICHARD L KEUHN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 S WADSWORTH BLVD
LAKEWOOD CO
80226-1513
US

IV. Provider business mailing address

65 S WADSWORTH BLVD
LAKEWOOD CO
80226-1513
US

V. Phone/Fax

Practice location:
  • Phone: 303-934-3600
  • Fax: 303-934-1559
Mailing address:
  • Phone: 303-934-3600
  • Fax: 303-934-1559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2244
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: