Individual
MRS. JUDY MARIE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
328 STANFORD AVENUE, ELYRIA, OH 44035
(440) 281-8051
Mailing address
328 STANFORD AVENUE, ELYRIA, OH 44035
(440) 281-8051
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
OH
3747P1801X
Personal Care Attendant
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000232221
—
OH
Enumeration date
01/27/2021
Last updated
01/27/2021
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