Provider Demographics
NPI:1962299958
Name:KEITH, CHRISTIAN (JD)
Entity type:Individual
Prefix:MISS
First Name:CHRISTIAN
Middle Name:
Last Name:KEITH
Suffix:
Gender:
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 SHERIDAN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45403-2782
Mailing Address - Country:US
Mailing Address - Phone:773-954-4443
Mailing Address - Fax:
Practice Address - Street 1:512 SHERIDAN AVE APT 3
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-2782
Practice Address - Country:US
Practice Address - Phone:773-954-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach