Organization
KEYS CHIROPRACTIC, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY A KEYS D.C. (PRESIDENT)
(260) 420-8803
Entity
Organization
Contact information
Practice address
2422 LAKE AVE, PARK LAKE MEDICAL BLDG, FORT WAYNE, IN 46805-5406
(260) 420-8803
(260) 420-6814
Mailing address
2422 LAKE AVE, PARK LAKE MEDICAL BLDG, FORT WAYNE, IN 46805-5406
(260) 420-8803
(260) 420-6814
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001845A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000190008
BCBS
IN
01
—
152800
MEDICARE
IN
Enumeration date
08/07/2007
Last updated
08/07/2007
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