Healthcare Provider Details

I. General information

NPI: 1740526789
Provider Name (Legal Business Name): ROBER GARY KEHLER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2012
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 ROUTE 517 VILLAGE SQUARE AT PANTHER VALLEY
ALLAMUCHY NJ
07820
US

IV. Provider business mailing address

29 HAYTOWN RD
LEBANON NJ
08833-4010
US

V. Phone/Fax

Practice location:
  • Phone: 908-813-8200
  • Fax:
Mailing address:
  • Phone: 908-813-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00340800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: