Provider Demographics
NPI:1386708329
Name:VOLSTAD, KEITH L (DC)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:L
Last Name:VOLSTAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:875 MILITARY TRL STE 208
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5700
Mailing Address - Country:US
Mailing Address - Phone:561-746-4242
Mailing Address - Fax:561-880-0244
Practice Address - Street 1:875 MILITARY TRL STE 208
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5700
Practice Address - Country:US
Practice Address - Phone:561-746-4242
Practice Address - Fax:561-746-7405
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55443OtherBCBS
FL55443Medicare ID - Type Unspecified