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General NPI Number Information
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NPI Number | 1902199177
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Entity Type | Organization
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Legal Business Name | JEFFREY J KEON & DINA J KEON, A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 11/22/2019
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Provider Practice Location Address
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Address Line | 2025 HURLEY WAY STE 110
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City | SACRAMENTO
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State | CA
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Zip | 95825-3225
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Country | US
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Telephone | 916-487-3008
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Fax | 916-487-1197
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Provider Business Mailing Address
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Address Line | 1260 FULTON AVE STE A
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City | SACRAMENTO
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State | CA
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Zip | 95825-7396
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Country | US
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Telephone | 916-487-3008
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Fax | 916-487-1197
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY KEON
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Credential | D.C.
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Telephone | 916-487-3008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC25579
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License Number State | CA
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