Healthcare Provider Details

I. General information

NPI: 1427156058
Provider Name (Legal Business Name): KEITH O. HOYT D.C., CCEP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14823 VALLEY VIEW DR
MOUNT VERNON WA
98273-3281
US

IV. Provider business mailing address

14823 VALLEY VIEW DR
MOUNT VERNON WA
98273-3281
US

V. Phone/Fax

Practice location:
  • Phone: 360-428-3669
  • Fax:
Mailing address:
  • Phone: 360-428-3669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberCHOOOO1907
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: