Healthcare Provider Details

I. General information

NPI: 1831226588
Provider Name (Legal Business Name): MAUREEN (MOLLY) ANN KEEFE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 N MAIN ST
SAINT ALBANS VT
05478-1551
US

IV. Provider business mailing address

128 N MAIN ST
SAINT ALBANS VT
05478-1551
US

V. Phone/Fax

Practice location:
  • Phone: 802-527-2225
  • Fax: 802-527-2013
Mailing address:
  • Phone: 802-527-2225
  • Fax: 802-527-2013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberVT982
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: