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General NPI Number Information
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NPI Number | 1962409631
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Entity Type | Individual
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Provider Name | KEITH L HEDIGER D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 3858 LAKE ST STE. 20
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City | HOMER
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State | AK
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Zip | 99603-7682
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Country | US
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Telephone | 907-235-7221
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Fax | 907-235-3430
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Provider Business Mailing Address
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Address Line | 3858 LAKE ST STE. 20
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City | HOMER
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State | AK
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Zip | 99603-7682
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Country | US
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Telephone | 907-235-7221
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Fax | 907-235-3430
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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 | 124
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License Number State | AK
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