Individual
DR. DOUGLAS EDWARD KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
540 E GRAND AVE, BELOIT, WI 53511-6314
(608) 365-8575
(608) 362-2625
Mailing address
531 E GRAND AVE, BELOIT, WI 53511-6313
(608) 365-8575
(608) 362-2655
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3136-035
WI
Other
Enumeration date
05/19/2008
Last updated
07/05/2016
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