Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 2350 | CO |
NPI | 1114122082 |
---|---|
Provider Name | Dr. Lowell Joseph Keppel |
First Address | Federal Heights, CO 80260-5811 |
Second Address | Federal Heights, CO 80260-5811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 08/07/2007 |