Keller, Tracy L

Keller, Tracy L is an individual health care provider with primary practice located at 1245 Washington Ave , Detroit Lakes MN 56501-3905. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Keller, Tracy L can be contacted via phone (218) 846-2000.

Contact Information

Primary practice address
1245 Washington Ave Detroit Lakes MN 56501-3905
Phone: (218) 846-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1141 North Dakota
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 7331 Minnesota

Profile Details

NPI number 1629015300
LBN Legal business name Keller, Tracy L
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Nov 20th, 2017 - about 7 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 1629015300 NPPES
North Dakota MEDICAID 54087
North Dakota Other DA9011015523
North Dakota Other HP53308
North Dakota Other 26770
North Dakota Other 6406051
North Dakota Other 037H4LU

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