Individual
KEITH ALAN CLOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
330 BROADWAY ST, MOUNT VERNON, IL 62864-5116
(618) 241-9211
(618) 241-9212
Mailing address
330 BROADWAY ST, MOUNT VERNON, IL 62864-5116
(618) 241-9211
(618) 241-9212
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008422
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038008422
—
IL
01
—
4122210
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/20/2007
Last updated
10/29/2010
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