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General NPI Number Information
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NPI Number | 1396898565
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Entity Type | Individual
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Provider Name | KEITH J GRAVES D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 1776 S JACKSON ST STE 1005
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City | DENVER
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State | CO
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Zip | 80210-3809
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Country | US
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Telephone | 303-756-0360
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Fax | 303-484-2860
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Provider Business Mailing Address
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Address Line | 1776 S JACKSON ST STE 1005
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City | DENVER
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State | CO
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Zip | 80210-3809
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Country | US
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Telephone | 303-756-0360
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Fax | 303-675-6488
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3792
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License Number State | CO
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