Individual
MR. PHELO JOSEPH KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTSC
Contact information
Practice address
1300 LAKEWOOD DR SUITE D, MORGAN CITY, LA 70380
(985) 384-7900
(985) 384-8049
Mailing address
PO BOX 2375, MORGAN CITY, LA 70381
(985) 384-7900
(985) 384-8049
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
NBCOT981110
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950290
OTC NATIONAL
—
01
—
981110
NBCOT
LA
Enumeration date
12/18/2006
Last updated
07/08/2007
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