MEDICARE: KEITH REGAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5263	AZ

General Provider Information

NPI Number	:	1144454620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH REGAN D.C.

Provider Business Mailing Address
First Line	:	7210 N CASABLANCA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-1312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7210 N CASABLANCA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-1312
Country	:	US
Telephone Number	:	520-544-2992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2009
Last Update Date	:	05/12/2009

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Directions to “ KEITH REGAN D.C.” Practice Location

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