Organization
DR DANIEL KELDERHOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN MORRIS (OFFICE MGR)
(419) 334-8941
Entity
Organization
Contact information
Practice address
201 S PARK AVE, FREMONT, OH 43420-2953
(419) 334-8941
Mailing address
201 S PARK AVE, FREMONT, OH 43420-2953
(419) 334-8941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-00-3555
OH
208D00000X
General Practice Physician
34-00-3555
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0519782
—
OH
Enumeration date
10/26/2007
Last updated
02/12/2009
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