Individual
MARY JANE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR CHT
Contact information
Practice address
8554 HWY 51 N, UNIT 617, MINOCQUA, WI 54548
(715) 358-1929
(715) 356-4031
Mailing address
PO BOX 11, EXCEL REHAB AND SPINE CENTER INC, MINOCQUA, WI 54548
(715) 358-1929
(715) 356-4031
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1752026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40811700
—
WI
Enumeration date
10/18/2006
Last updated
06/09/2008
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