| Doctor Name: | TRISTAN DEAN KEELER |
| NPI Number: | 1043627599 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 4101 S 4th St Leavenworth, KS - 660485014 |
| Business Phone Number: | 9136822000 |
| Business Fax Number: | 9137584111 |
| Mailing Address: | 4101 S 4th St, LEAVENWORTH |
| State: | KS |
| Postal Code: | 660485014 |
| Phone Number: | 9136822000 |
| Fax Number: | 9137584111 |
| NPI Enumeration Date: | 07/16/2014 |
| NPI Last Update Date: | 07/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246RP1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Pathology |
| Taxonomy Specialization: | Phlebotomy |
| Taxonomy Definition: | |