Individual
DR. AUTUMN RENEE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
659 E BROADWAY ST, TOLEDO, OH 43605-2701
(419) 698-2008
(419) 698-2640
Mailing address
813 TAPPAN ST, MAUMEE, OH 43537-3557
(419) 887-1531
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3204
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4066521
—
OH
Enumeration date
09/22/2006
Last updated
07/08/2007
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