Organization100 Chiro Keller, Pllc.ChiropractorChiropractic ProvidersPractice Address5956 N Linder Rd., Suite 120, Meridian, ID 83646(815) 977-1931PECOS EnrollmentBased on the most recent information from CMS, provider 100 Chiro Keller, Pllc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1659091726Provider TypeOrganizationFull Name100 Chiro Keller, Pllc.SubpartNoEnumeration Date8/30/2022Last Updated8/30/2022Contact InformationPractice LocationPractice Address5956 N Linder Rd., Suite 120, Meridian, ID 83646Phone(815) 977-1931FaxUnlisted FaxMailing LocationMailing Address5956 N Linder Rd., Suite 120, Meridian, ID 83646Phone(815) 977-1931FaxUnlisted FaxAuthorized OfficialNameKeller, David T (Chiropractor/Owner)Phone(815) 977-1931Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseUnlisted Issuer