Individual
DR. KEITH W KENITZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
700 GAGEL AVE, LOUISVILLE, KY 40216-4008
(502) 366-7386
(502) 366-2222
Mailing address
700 GAGEL AVE, LOUISVILLE, KY 40216-4008
(502) 366-7386
(502) 366-2222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3816
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221631
ANTHEM
KY
01
—
1136138
PASSPORT
KY
01
—
350036040
UNITED RAILROAD MEDICARE
KY
01
—
611274059A12
ANTHEM SENIOR
KY
05
—
85002103
—
KY
Enumeration date
06/01/2005
Last updated
04/15/2009
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