Individual
DR. JAMES (JIM) L KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, PT
Contact information
Practice address
2929 S CARAWAY RD, SUITE 15, JONESBORO, AR 72401-7307
(870) 935-1414
(870) 935-1425
Mailing address
2929 S CARAWAY RD, SUITE 15, JONESBORO, AR 72401-7307
(870) 935-1414
(870) 935-1425
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
104
TN
225100000X
Physical Therapist
5614
SC
225100000X
Physical Therapist
Primary
PT176
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11424712
CAQH
AR
05
—
121901721
—
AR
05
—
149795742
—
AR
01
—
71076580230
QUALCHOICE
AR
Enumeration date
06/29/2006
Last updated
04/05/2019
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