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General NPI Number Information
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NPI Number | 1750577102
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Entity Type | Individual
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Provider Name | CHRISTINA HAAS KELLER D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 209 STEVENS ST
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City | NEENAH
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State | WI
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Zip | 54956-2961
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Country | US
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Telephone | 920-915-6655
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Fax |
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Provider Business Mailing Address
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Address Line | 209 STEVENS STREET
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City | NEENAH
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State | WI
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Zip | 54956
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Country | US
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Telephone | 920-558-4885
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6504-024
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License Number State | WI
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