Individual
MS. AUTUMN LEE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
111 RILEY CIR, DAWSONVILLE, GA 30534-6659
(770) 530-1754
Mailing address
111 RILEY CIR, DAWSONVILLE, GA 30534-6659
(770) 530-1754
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
BOC337153
GA
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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