Provider Demographics
NPI:1376970806
Name:KELLER, DANIEL ROBERT (DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:KELLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 MEYER RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1954
Mailing Address - Country:US
Mailing Address - Phone:716-563-4811
Mailing Address - Fax:716-217-6332
Practice Address - Street 1:425 MEYER RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1954
Practice Address - Country:US
Practice Address - Phone:716-563-4811
Practice Address - Fax:716-217-6332
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist