Individual
JESSICA RAE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
4201 S WASHINGTON ST, MARION, IN 46953-4974
(765) 677-1676
Mailing address
4611 S WASHINGTON ST, MARION, IN 46953-5209
(765) 621-5566
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001029A
IN
Other
Enumeration date
02/24/2006
Last updated
04/17/2015
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