Individual
BROOK KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
8371 FAIRLANE DR APT 5, BIRCH RUN, MI 48415-9774
(989) 323-7489
Mailing address
8371 FAIRLANE DR APT 5, BIRCH RUN, MI 48415-9774
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008485
MI
224Z00000X
Occupational Therapy Assistant
—
—
Other
Enumeration date
04/01/2020
Last updated
04/29/2020
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