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General NPI Number Information
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NPI Number | 1396541132
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Entity Type | Individual
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Provider Name | JENNIFER ISABELLE KELLER DC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 3910 SCHOFIELD AVE STE 7A
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City | WESTON
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State | WI
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Zip | 54476-6800
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Country | US
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Telephone | 715-638-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 ALDERSON ST APT 29
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City | SCHOFIELD
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State | WI
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Zip | 54476-3645
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Country | US
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Telephone | 651-239-7078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6285-12
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License Number State | WI
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