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NPI Code Detail

MEDICARE: ZACHARY KELLER P.T.

MEDICARE:   ZACHARY  KELLER  P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1174028TX

General Provider Information

NPI Number : 1750548251
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY KELLER P.T.
Provider Business Mailing Address
First Line : 2600 COLE AVE APT 216
Second Line :
City : DALLAS
State : TX
Zip : 75204-0949
Country : US
Telephone Number : 405-249-0794
Fax Number :
Provider Business Practice Location Address
First Line : 2600 COLE AVE APT 216
Second Line :
City : DALLAS
State : TX
Zip : 75204-0949
Country : US
Telephone Number : 405-249-0794
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2008
Last Update Date : 09/18/2024

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Directions to “ ZACHARY KELLER P.T.” Practice Location

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