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DR. JORDAN DANIEL KECK DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1871950998

Individual Registrant:
DR. JORDAN DANIEL KECK DC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
528 N STATE ST  SHELLEY, ID 83274-1154 US
Tel: 208-357-0333  Fax: 208-357-2299

Contact information for business:
528 N STATE ST  SHELLEY, ID 83274-1154 US
Tel: 208-357-0333  Fax: 208-357-2299

Registration Information:
NPI: 1871950998
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
IDCHIA-1673

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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