Organization
LISA S KELLER OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA KELLER O.D. (PRESIDENT)
(314) 497-3042
Entity
Organization
Contact information
Practice address
1205 W FERDON ST, LITCHFIELD, IL 62056-4454
(217) 324-5004
(217) 324-5438
Mailing address
508 PATTON DR, TROY, IL 62294-3103
(314) 497-3042
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
046.010168
IL
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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