Individual
JAKE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4901 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5647
(585) 341-2000
Mailing address
4901 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5647
(585) 341-2000
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
043723-1
NY
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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