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Individual

DR. KEITH P MINIHANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1338 PHAY AVE, CANON CITY, CO 81212-2302
(719) 285-2646
(719) 285-2647
Mailing address
1338 PHAY AVE, CANON CITY, CO 81212-2302
(719) 285-2646
(719) 285-2647

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036109086
IL
207X00000X
Orthopaedic Surgery Physician
Primary
46332
CO

Other

Enumeration date
10/24/2005
Last updated
09/24/2013
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