Provider Demographics
NPI:1093607285
Name:HUDZIAK, KEIGHLEY (CHIROPRACTIC, DC)
Entity type:Individual
Prefix:
First Name:KEIGHLEY
Middle Name:
Last Name:HUDZIAK
Suffix:
Gender:F
Credentials:CHIROPRACTIC, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 HAMILTON STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1626
Mailing Address - Country:US
Mailing Address - Phone:615-200-0203
Mailing Address - Fax:
Practice Address - Street 1:1050 HAMILTON STATION BLVD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1626
Practice Address - Country:US
Practice Address - Phone:615-200-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor