=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851428031
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEAN KEITH DENNING DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 160 SO J STREET
-----------------------------------------------------
City | TULARE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93274
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-688-0623
-----------------------------------------------------
Fax | 559-688-0623
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 160 SO J STREET
-----------------------------------------------------
City | TULARE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93274
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-688-0623
-----------------------------------------------------
Fax | 559-688-0623
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 11424
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------