Individual
MRS. JENNIFER NICOLE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
15525 POMERADO RD, STE D4, POWAY, CA 92064-2435
(858) 674-1600
(858) 674-1606
Mailing address
PO BOX 28199, SAN DIEGO, CA 92198-0199
(858) 675-3100
(858) 618-1523
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT29944
CA
Other
Enumeration date
07/11/2006
Last updated
04/24/2014
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