Provider Demographics
NPI:1295339349
Name:KECKLER, LEANNE
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:KECKLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S US HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-9687
Mailing Address - Country:US
Mailing Address - Phone:419-455-5959
Mailing Address - Fax:
Practice Address - Street 1:410 S US HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-9687
Practice Address - Country:US
Practice Address - Phone:419-455-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker