Individual
JENNIFER KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
924 S COMMERCIAL ST, HARRISBURG, IL 62946-2637
(618) 252-7171
Mailing address
2 FAIRVIEW AVE, ANNA, IL 62906-1156
(618) 697-4523
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006702
IL
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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