Provider Demographics
NPI:1306166996
Name:KEETH, MELENA (DC)
Entity type:Individual
Prefix:DR
First Name:MELENA
Middle Name:
Last Name:KEETH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 NW 50TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8004
Mailing Address - Country:US
Mailing Address - Phone:405-445-6126
Mailing Address - Fax:877-866-2141
Practice Address - Street 1:2828 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8004
Practice Address - Country:US
Practice Address - Phone:405-445-6126
Practice Address - Fax:877-866-2141
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor