Individual
DR. GLEN E KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10400 LANCASTER NEWARK RD NE, MILLERSPORT, OH 43046-8003
(740) 467-2486
(740) 467-2498
Mailing address
10400 LANCASTER NEWARK RD NE, MILLERSPORT, OH 43046-8003
(740) 467-2486
(740) 467-2498
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3369
OH
111N00000X
Chiropractor
CHIA 576
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000509974
BLUE CROSS
OH
01
—
1003201
AMERICAN SPECIALTY HEALTH
OH
01
—
11176716
CAQH
OH
05
—
2474059
—
OH
01
—
5585251
AETNA
OH
01
—
665855
AMERICAN CHIRO NTWRK(ACN)
OH
Enumeration date
01/17/2006
Last updated
04/08/2008
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