Provider Demographics
NPI:1225522840
Name:KELLER, ALEXA THERESA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:THERESA
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 1:807 CHERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8283
Mailing Address - Country:US
Mailing Address - Phone:937-478-2477
Mailing Address - Fax:
Practice Address - Street 1:31 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2203
Practice Address - Country:US
Practice Address - Phone:513-409-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-04917111N00000X
NC4909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor