# DR. GLEN E KELLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1730169897
- **Gender:** Man
- **Credential:** D.C.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3369 | OH | Yes |
| 111N00000X | Chiropractor | CHIA 576 | ID | — |

## Other

- **Enumeration date:** 01/17/2006
- **Last updated:** 04/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000509974 | BLUE CROSS | OH |
| 01 | — | 1003201 | AMERICAN SPECIALTY HEALTH | OH |
| 01 | — | 11176716 | CAQH | OH |
| 05 | — | 2474059 | — | OH |
| 01 | — | 5585251 | AETNA | OH |
| 01 | — | 665855 | AMERICAN CHIRO NTWRK(ACN) | OH |