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General NPI Number Information
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NPI Number | 1386274173
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Entity Type | Organization
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Legal Business Name | KELLER CHIROPRACTIC OF OWOSSO P.C.
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 210 W MAIN ST
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City | OWOSSO
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State | MI
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Zip | 48867-2914
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Country | US
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Telephone | 989-723-2039
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 WARD ST
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City | OWOSSO
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State | MI
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Zip | 48867-1435
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Country | US
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Telephone | 563-343-4162
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS KELLER
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Credential | DC
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Telephone | 989-723-2039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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