Provider Demographics
NPI:1841364809
Name:KELLER, MARGARET ELIZABETH (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:KELLER
Suffix:
Gender:F
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:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-0215
Mailing Address - Country:US
Mailing Address - Phone:785-594-3746
Mailing Address - Fax:785-594-0503
Practice Address - Street 1:491 E.1814 RD.
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-0215
Practice Address - Country:US
Practice Address - Phone:785-594-2506
Practice Address - Fax:785-594-0503
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1700449174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist