Individual
DR. MARK DAVID KEELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4011 TAYLOR BLVD, LOUISVILLE, KY 40215-2542
(502) 367-7114
(502) 367-7108
Mailing address
4011 TAYLOR BLVD, LOUISVILLE, KY 40215-2542
(502) 367-7114
(502) 367-7108
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4197
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051682
ANTHEM BCBS
KY
01
—
1121409
PASSPORT
KY
05
—
85041978
—
KY
Enumeration date
02/13/2007
Last updated
07/09/2007
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