Healthcare Provider Details

I. General information

NPI: 1326169541
Provider Name (Legal Business Name): KEITA L VANTERPOOL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9131 PISCATAWAY RD STE 150
CLINTON MD
20735-2510
US

IV. Provider business mailing address

PO BOX 30276
WASHINGTON DC
20030-0276
US

V. Phone/Fax

Practice location:
  • Phone: 240-523-3880
  • Fax:
Mailing address:
  • Phone: 202-744-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH30018
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberSO3383
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberCH30018
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: