=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558283598
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBBIN T KELLER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2026
-----------------------------------------------------
Last Update Date | 07/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 160 WESTMOUNT DR
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63640-2970
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-898-7784
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1026 WOLF CREEK DR
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63640-7661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-631-9208
-----------------------------------------------------
Fax | 573-631-9208
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 2005001143
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------