| Keough Chiropractic, Inc | |
|
12139 Mount Vernon Ave Ste 100, Grand Terrace, CA 92313-5519 | |
| (909) 783-4950 | |
| (909) 783-1008 |
| Full Name | Keough Chiropractic, Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 12139 Mount Vernon Ave Ste 100, Grand Terrace, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104026913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Kelly Patrick Keough |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1407886153 PECOS PAC ID: 1759358807 Enrollment ID: I20040917000274 |
| Mailing Address | Practice Location Address |
|---|---|
| Keough Chiropractic, Inc 12139 Mount Vernon Ave Ste 100, Grand Terrace, CA 92313-5519 Ph: (909) 783-4950 | Keough Chiropractic, Inc 12139 Mount Vernon Ave Ste 100, Grand Terrace, CA 92313-5519 Ph: (909) 783-4950 |
Dr. Kelly Patrick Keough, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: 12139 Mount Vernon Ave Ste 100, Grand Terrace, CA 92313 Phone: 909-783-4950 Fax: 909-783-1008 | |
Dr. Richard Trujillo, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 12139 Mount Vernon Ave Ste 100, Grand Terrace, CA 92313 Phone: 909-783-4950 | |
Dr. Gilbert Nmn Hernandez Jr., D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 22448 Barton Rd, Grand Terrace, CA 92313 Phone: 909-370-1564 Fax: 909-370-0564 | |
Dr. Zakari Larbi Bissani, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 12139 Mount Vernon Ave Ste 100, Grand Terrace, CA 92313 Phone: 720-989-0890 |