Provider Demographics
NPI:1992900625
Name:DOWNTOWN CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:DOWNTOWN CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KEILS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-664-3333
Mailing Address - Street 1:793 S MAIN ST
Mailing Address - Street 2:STE. A
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3094
Mailing Address - Country:US
Mailing Address - Phone:810-664-3333
Mailing Address - Fax:810-664-1361
Practice Address - Street 1:793 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3094
Practice Address - Country:US
Practice Address - Phone:810-664-3333
Practice Address - Fax:810-664-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJK005705111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty