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1588230429
LUCAS KELLER
MERIDIAN, ID
NPI
1588230429
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: ID PT-7368)
Enumeration Date
2021-06-01
Last Update Date
2021-06-01
Business Address
LUCAS KELLER
3080 E GENTRY WAY STE 180
MERIDIAN, ID 83642-3014
Phone number: 208-939-3334
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Mailing Address
LUCAS KELLER
17850 28TH ST NW
BALDWIN, ND 58521-9773
Phone number: 701-471-6016
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