Provider Demographics
NPI:1992941843
Name:KEEM, MATTHEW PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PAUL
Last Name:KEEM
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 1:1205 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2923
Mailing Address - Country:US
Mailing Address - Phone:585-872-9211
Mailing Address - Fax:585-872-9311
Practice Address - Street 1:1205 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2923
Practice Address - Country:US
Practice Address - Phone:585-872-9211
Practice Address - Fax:585-872-9311
Is Sole Proprietor?:No
Enumeration Date:2008-12-24
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011620111N00000X
CT001785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor