Kelly Patrick Keough (NPI# 1407886153, PAC ID# 1759358807) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.
| Nation Provider ID (NPI) | 1407886153 |
| PAC ID by PECOS | 1759358807 |
| Professional Enrollment ID | I20040917000274 |
| Full Name | Kelly Patrick Keough |
| Address |
12139 Mount Vernon Ave Suite 100 Grand Terrace CA 92313-5519 |
| Gender | M |
| Credential | DC |
| Medical School | LIFE CHIROPRACTIC COLLEGE - WEST |
| Graduation Year | 1980 |
| Primary Specialty | CHIROPRACTIC |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 12139 Mount Vernon Ave, Suite 100, Grand Terrace, CA 92313-5519 |
| Street Address |
12139 MOUNT VERNON AVE SUITE 100 |
| City | GRAND TERRACE |
| State | CA |
| Zip | 92313-5519 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sheila Renee Jones-lilley | Occupational Therapy | Total Care Physical Therapy Inc | 12139 Mount Vernon Ave, Suite 110, Grand Terrace, CA 92313-5500 |
| Farid F Khattar | Physical Therapy | Total Care Physical Therapy Inc | 12139 Mount Vernon Ave, Suite 110, Grand Terrace, CA 92313-5500 |
| Richard John Trujillo | Chiropractic | 12139 Mount Vernon Ave, Suite 100, Grand Terrace, CA 92313-5519 | |
| Jeremy J Mumu | Physical Therapy | Total Care Physical Therapy Inc | 12139 Mount Vernon Ave, Suite 110, Grand Terrace, CA 92313-5500 |
| Heather Rae Thielen | Occupational Therapy | Total Care Physical Therapy Inc | 12139 Mount Vernon Ave, Grand Terrace, CA 92313-5500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shellee R Lazar | Obstetrics/gynecology | Riverside-san Bernardino County Indian Health, Inc. | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 |
| Aidan M Clarke | Physical Medicine and Rehabilitation | Riverside-san Bernardino County Indian Health, Inc. | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 |
| Reshmi Sinha | Family Medicine | Riverside-san Bernardino County Indian Health, Inc. | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 |
| Cynthia M Nakoski | Psychologist, Clinical | Riverside-san Bernardino County Indian Health, Inc. | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 |
| Timothy Li | Family Practice | Riverside-san Bernardino County Indian Health, Inc. | 11980 Mount Vernon Ave, Grand Terrace, CA 92313-5172 |
| Robert W Nguyen | Geriatric Medicine | 12000 Mount Vernon Ave, Grand Terrace, CA 92313-5174 | |
| Richard C Ortiz | Physical Therapy | 22908 Wren St, Grand Terrace, CA 92313-5580 |
| City | GRAND TERRACE |
| Zip Code | 92313 |
| Specialty | CHIROPRACTIC |
| City + Specialty | GRAND TERRACE + CHIROPRACTIC |
Please comment or provide details below to improve the information on Kelly Patrick Keough.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.