Individual
MRS. PAMELA DENISE KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST MA.,CCCA
Contact information
Practice address
4444 KALAMAZOO AVE SE, KENTWOOD, MI 49508-4600
(616) 455-9180
(616) 574-0215
Mailing address
961 4 MILE RD NW, GRAND RAPIDS, MI 49544-8252
(616) 455-9180
(616) 574-0215
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000146
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804784633
—
MI
Enumeration date
07/05/2006
Last updated
05/25/2016
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