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General NPI Number Information
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NPI Number | 1114126182
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Entity Type | Organization
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Legal Business Name | KEEHN CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 1241 STATE AVE STE 101
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City | MARYSVILLE
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State | WA
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Zip | 98270-3612
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Country | US
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Telephone | 360-659-8411
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Fax | 360-658-1033
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Provider Business Mailing Address
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Address Line | 1241 STATE AVE STE 101
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City | MARYSVILLE
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State | WA
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Zip | 98270-3612
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Country | US
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Telephone | 360-659-8411
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Fax | 360-658-1033
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. STEPHEN RICHARD KEEHN
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Credential | D.C.
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Telephone | 360-659-8411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 600424793
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License Number State | WA
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