MEDICARE: DR. KRISTOPHER K KELLER D.C., D.A.B.C.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	1358	OH

General Provider Information

NPI Number	:	1306871991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTOPHER K KELLER D.C., D.A.B.C.O.

Provider Business Mailing Address
First Line	:	422 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1833
Country	:	US
Telephone Number	:	614-885-4480
Fax Number	:	614-885-1066

Provider Business Practice Location Address
First Line	:	422 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1833
Country	:	US
Telephone Number	:	614-885-4480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	02/11/2019

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