Individual
DR. CHARLES E KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
103 W SAINT CLAIR ST, WARREN, PA 16365-2197
(814) 726-2020
(814) 726-1215
Mailing address
27 PORTER AVE, JAMESTOWN, NY 14701-6221
(716) 483-2020
(716) 488-9295
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE5123T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000546016
—
PA
Enumeration date
11/18/2005
Last updated
09/08/2010
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