Individual
DIANE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2204 STAPLES RD, MOBILE, AL 36605-4520
(251) 490-0658
Mailing address
2204 STAPLES RD, MOBILE, AL 36605-4520
(251) 490-0658
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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