Provider Demographics
NPI:1487907549
Name:KEYSTONE NATURAL FAMILY MEDICINE
Entity type:Organization
Organization Name:KEYSTONE NATURAL FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWNITTA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-325-1977
Mailing Address - Street 1:10153 E HAMPTON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3326
Mailing Address - Country:US
Mailing Address - Phone:480-535-5688
Mailing Address - Fax:
Practice Address - Street 1:10153 E HAMPTON AVE STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3326
Practice Address - Country:US
Practice Address - Phone:480-535-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty