Individual
TIM RYAN KEEHLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA
Contact information
Practice address
555 FAIRVIEW DR, ROCHELLE, IL 61068-2310
(815) 561-9003
(815) 562-6692
Mailing address
103 MAIN ST, CHANA, IL 61015-9732
(815) 501-7366
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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