Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1358 | OH |
NPI | 1306871991 |
---|---|
Provider Name | Dr. Kristopher K Keller |
First Address | Columbus, OH 43214-1833 |
Second Address | Columbus, OH 43214-1833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 11/02/2019 |