Provider Demographics
NPI:1386274173
Name:KELLER CHIROPRACTIC OF OWOSSO P.C.
Entity type:Organization
Organization Name:KELLER CHIROPRACTIC OF OWOSSO P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-723-2039
Mailing Address - Street 1:1005 WARD ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1435
Mailing Address - Country:US
Mailing Address - Phone:563-343-4162
Mailing Address - Fax:
Practice Address - Street 1:210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2914
Practice Address - Country:US
Practice Address - Phone:989-723-2039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty