Provider Demographics
NPI:1649292087
Name:KELLER, LAWRENCE JEFFREY (DC)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JEFFREY
Last Name:KELLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH RD
Mailing Address - Street 2:SUITE111
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4727
Mailing Address - Country:US
Mailing Address - Phone:561-729-0502
Mailing Address - Fax:561-729-0589
Practice Address - Street 1:5700 LAKE WORTH RD
Practice Address - Street 2:SUITE111
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4727
Practice Address - Country:US
Practice Address - Phone:561-729-0502
Practice Address - Fax:561-729-0589
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor