Individual
MARY CELESTE KEISER
Active
Individual
MARY CELESTE KEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4455 / T1139
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122752
ANTHEM
—
01
—
311645431
AETNA
—
Enumeration date
08/30/2006
Last updated
11/10/2011
Update your record
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