Provider Demographics
NPI:1528367539
Name:KELLER, MELODY (ND)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:
Last Name:KELLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S ELLERY AVE
Mailing Address - Street 2:PO BOX 466
Mailing Address - City:FAIRVIEW
Mailing Address - State:MT
Mailing Address - Zip Code:59221-7210
Mailing Address - Country:US
Mailing Address - Phone:406-944-4101
Mailing Address - Fax:406-742-5968
Practice Address - Street 1:304 S ELLERY AVE
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:MT
Practice Address - Zip Code:59221-7210
Practice Address - Country:US
Practice Address - Phone:406-944-4101
Practice Address - Fax:406-742-5968
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT132175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath