Individual
LAURA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5000 PLEASANTON AVE, STE. 200, PLEASANTON, CA 94566-7052
(650) 785-4535
Mailing address
7100 SAN RAMON RD, APT 14, DUBLIN, CA 94568-3201
(360) 430-8014
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
SPECIALIST/TECHNOLOGIST - ATHLETIC TRAINER
—
Enumeration date
05/16/2016
Last updated
05/16/2016
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