Individual
LISA M KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
136 EUCLID AVE, WADSWORTH, OH 44281-1501
(330) 618-0285
(330) 230-7443
Mailing address
136 EUCLID AVE, WADSWORTH, OH 44281-1501
(330) 618-0285
(330) 336-8731
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009824
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2310743
—
OH
01
—
358260
ANTHEM
OH
Enumeration date
05/27/2006
Last updated
05/22/2015
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