Individual
TARA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3636 N RIDGE RD, BUILDING 400, WICHITA, KS 67205-1213
(316) 462-3636
Mailing address
3513 N VALERIE CIR, WICHITA, KS 67205-3410
(785) 565-3458
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03702
KS
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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