Healthcare Provider Details

I. General information

NPI: 1972446227
Provider Name (Legal Business Name): AIDAN KEEVA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W MAIN ST
WILMINGTON VT
05363-9680
US

IV. Provider business mailing address

PO BOX 88
MARLBORO VT
05344-0088
US

V. Phone/Fax

Practice location:
  • Phone: 847-903-5060
  • Fax:
Mailing address:
  • Phone: 847-903-5060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: AIDAN KEEVA
Title or Position: DOCTOR OF ACUPUNCTURE
Credential: DACM, LIC. AC.
Phone: 847-903-5060