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General NPI Number Information
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NPI Number | 1659187540
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Entity Type | Organization
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Legal Business Name | KET CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 405 S 100 E STE 104
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2751
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Country | US
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Telephone | 801-785-9411
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Fax | 888-431-2763
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Provider Business Mailing Address
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Address Line | 405 S 100 E STE 104
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2751
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Country | US
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Telephone | 801-785-9411
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Fax | 888-431-2763
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEREN RICE
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Credential | DC
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Telephone | 918-812-9866
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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 |
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License Number State |
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