Most Relevant Information
Provider Data
| NPI Number: | 1003544776 |
| Provider Name: | RICKY KELLER |
| Entity Type: | Individual |
| Taxonomy Code: | 253Z00000X |
| Specialty: | In Home Supportive Care |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/10/2022 |
| Last Updated: | 08/10/2022 |
Provider Practice Location
10235 N 31ST ST UNIT 16
PHOENIX
AZ
850283829
Practice Location Phone/Fax
| Phone: | 5733808637 |
| Fax: |
Provider Mailing Location
10235 N 31ST ST UNIT 16
PHOENIX
AZ
850283829
Provider Mailing Phone/Fax
| Phone: | 5733808637 |
| Fax: |