Provider Demographics
NPI:1891019378
Name:O'KEEFE, MICHAEL SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:O'KEEFE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 OAK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-7411
Mailing Address - Country:US
Mailing Address - Phone:401-934-0077
Mailing Address - Fax:
Practice Address - Street 1:6 VILLAGE PLAZA WAY
Practice Address - Street 2:
Practice Address - City:NORTH SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1849
Practice Address - Country:US
Practice Address - Phone:401-934-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor