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General NPI Number Information
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NPI Number | 1720520901
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Entity Type | Organization
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Legal Business Name | KEENAN CHIROPRACTIC SPINE AND INJURY CENTER LLC
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Dates
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Enumeration Date | 11/05/2016
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Last Update Date | 01/02/2017
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Provider Practice Location Address
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Address Line | 501A LONG HOLLOW PIKE
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3448
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Country | US
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Telephone | 615-693-9825
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Fax |
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Provider Business Mailing Address
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Address Line | 501A LONG HOLLOW PIKE
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3448
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Country | US
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Telephone | 615-693-9825
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEITH KEENAN
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Credential | D. C.
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Telephone | 615-693-9825
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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 | 2841
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License Number State | TN
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