Provider Demographics
NPI:1396541132
Name:KELLER, JENNIFER ISABELLE (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ISABELLE
Last Name:KELLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 ALDERSON ST APT 29
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-3645
Mailing Address - Country:US
Mailing Address - Phone:651-239-7078
Mailing Address - Fax:
Practice Address - Street 1:3910 SCHOFIELD AVE STE 7A
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-6800
Practice Address - Country:US
Practice Address - Phone:715-638-1981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6285-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor