Provider Demographics
NPI:1740339670
Name:KEELER, LINDON WOOD (DC)
Entity type:Individual
Prefix:DR
First Name:LINDON
Middle Name:WOOD
Last Name:KEELER
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 1:2406 IRON ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3819
Mailing Address - Country:US
Mailing Address - Phone:360-715-9010
Mailing Address - Fax:360-715-9005
Practice Address - Street 1:2406 IRON ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3819
Practice Address - Country:US
Practice Address - Phone:360-715-9010
Practice Address - Fax:360-715-9005
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2685111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU34845Medicare UPIN