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General NPI Number Information
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NPI Number | 1497957302
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Entity Type | Individual
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Provider Name | KERRY LYNN KEISER D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1274 MORENA BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92110-3815
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Country | US
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Telephone | 619-276-7575
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Fax | 619-276-6362
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Provider Business Mailing Address
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Address Line | 549 ORANGE AVE
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City | CORONADO
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State | CA
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Zip | 92118-1826
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Country | US
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Telephone | 619-437-4900
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Fax | 619-276-6362
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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 | DC22030
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License Number State | CA
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