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General NPI Number Information
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NPI Number | 1619008422
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Entity Type | Individual
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Provider Name | STAFFORD VIRGIL KEELS D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 PENNSYLVANIA AVE SE SUITE 100
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City | WASHINGTON
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State | DC
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Zip | 20003-4316
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Country | US
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Telephone | 202-544-0577
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Fax | 202-544-0578
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Provider Business Mailing Address
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Address Line | 4 BAYSWATER RD 13 KINGS RD
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City | QUINBY
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State | SC
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Zip | 29506-7400
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Country | US
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Telephone |
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Fax |
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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 | CH030047
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License Number State | DC
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