Keller, Jarrod Ralph

Keller, Jarrod Ralph is an sole proprietor health care provider with primary practice located at 1066 Boiling Springs Rd , Spartanburg SC 29303-2247. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Keller, Jarrod Ralph can be contacted via phone (864) 582-0286.

Contact Information

Primary practice address
1066 Boiling Springs Rd Spartanburg SC 29303-2247
Fax: (864) 582-0279
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X SC1359 South Carolina

Profile Details

NPI number 1306889548
LBN Legal business name Keller, Jarrod Ralph
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Sep 25th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306889548 NPPES
South Carolina MEDICAID D13590

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