Individual
MR. SAMUEL RAY KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT
Contact information
Practice address
1939 NE DIAMOND LAKE BLVD, ROSEBURG, OR 97470-3573
(541) 957-5646
Mailing address
964 SE TERRACE DR, ROSEBURG, OR 97470-4330
(909) 533-9377
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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