Individual
DEBORAH SUZANNE KELLER
Active
Individual
DEBORAH SUZANNE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1158718
TX
225100000X
Physical Therapist
J1-0002104
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144328345
DPCI
DE
05
—
1144328345
—
DE
01
—
3748325000
IBC
DE
01
—
P00692870
MEDICARE RR
DE
Enumeration date
09/20/2006
Last updated
06/24/2010
Update your record
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