MEDICARE: JESSICA ELISABETH KELLER DPT

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	225100000X	Physical Therapist	3979	NH
2	225100000X	Physical Therapist	DAPT006162	PA
3	225100000X	Physical Therapist	PT032362	PA

General Provider Information

NPI Number	:	1508245051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ELISABETH KELLER DPT

Provider Business Mailing Address
First Line	:	332 HIDDEN CREEK DR
Second Line	:
City	:	HATBORO
State	:	PA
Zip	:	19040-1617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 YORK RD
Second Line	:
City	:	WARMINSTER
State	:	PA
Zip	:	18974-4506
Country	:	US
Telephone Number	:	215-672-7373
Fax Number	:	215-672-7399

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

Provider Enumeration Date	:	05/29/2015
Last Update Date	:	02/06/2025

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