Individual
MS. TATAUM ELLEN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
870 W MAIN ST, GENEVA, OH 44041-1219
(440) 466-1141
Mailing address
3667 ABBOTTS MILL DR, WILLOUGHBY, OH 44094-6494
(440) 983-3389
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.007263RX
OH
Other
Enumeration date
11/29/2021
Last updated
11/29/2021
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