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General NPI Number Information
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NPI Number | 1669236741
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Entity Type | Individual
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Provider Name | JOHN STUART KEETH DC
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Gender | Male
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 3200 S CONGRESS AVE STE 102
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-9041
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Country | US
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Telephone | 561-877-5525
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Fax |
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Provider Business Mailing Address
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Address Line | 630 E WOOLBRIGHT RD APT 309
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6198
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Country | US
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Telephone | 405-315-8636
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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 | 14552
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License Number State | FL
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