Provider Demographics
NPI:1659187540
Name:KET CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:KET CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-812-9866
Mailing Address - Street 1:405 S 100 E STE 104
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2751
Mailing Address - Country:US
Mailing Address - Phone:801-785-9411
Mailing Address - Fax:888-431-2763
Practice Address - Street 1:405 S 100 E STE 104
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2751
Practice Address - Country:US
Practice Address - Phone:801-785-9411
Practice Address - Fax:888-431-2763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty