Provider Demographics
NPI:1700943586
Name:KELLAR, WILLIAM E (LICAC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:KELLAR
Suffix:
Gender:M
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-5914
Mailing Address - Country:US
Mailing Address - Phone:781-648-6888
Mailing Address - Fax:
Practice Address - Street 1:155 MAIN DUNSTABLE RD
Practice Address - Street 2:SUITE 135
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3640
Practice Address - Country:US
Practice Address - Phone:603-566-1842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219604171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist