Provider Demographics
NPI:1821122284
Name:SCHELLER, KEITH ALLAN (OTR)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:ALLAN
Last Name:SCHELLER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3736 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-2885
Mailing Address - Country:US
Mailing Address - Phone:812-401-2638
Mailing Address - Fax:
Practice Address - Street 1:4000 TULIP TREE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-2300
Practice Address - Country:US
Practice Address - Phone:812-387-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003305A225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand