Individual
LINDA MAYE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 W JEFFERSON BLVD, SUITE 170, FORT WAYNE, IN 46804-6842
(260) 436-6544
Mailing address
4646 W JEFFERSON BLVD, SUITE 170, FORT WAYNE, IN 46804-6842
(260) 436-6544
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
C17211
IN
Other
Enumeration date
11/14/2007
Last updated
11/14/2007
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