Individual
OWEN J KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
525 S MAIN ST, ADA, OH 45810-6000
(419) 772-3135
(419) 772-2470
Mailing address
525 S MAIN ST, ADA, OH 45810-6000
(419) 772-3135
(419) 772-2470
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-000188
OH
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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