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Walt Keller, HSPP
NPI 1891052908 · on the registry since 2012
Practice
- Address
- 645 N Walnut St
Bloomington, IN 47404 - Phone
- (812) 336-3570
- Fax
- (812) 336-9010
- Organisation at this address
- Amethyst House
Amethyst House, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 8
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-04-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana