Healthcare Provider Details

I. General information

NPI: 1891019378
Provider Name (Legal Business Name): MICHAEL SCOTT O'KEEFE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 VILLAGE PLAZA WAY
NORTH SCITUATE RI
02857-1849
US

IV. Provider business mailing address

22 OAK HILL AVE
NORTH SMITHFIELD RI
02896-7411
US

V. Phone/Fax

Practice location:
  • Phone: 401-934-0077
  • Fax:
Mailing address:
  • Phone: 401-934-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP00589
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: