Individual
MR. MICHAEL J KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
105 MCKNIGHT DR, MIDDLETOWN, OH 45044-4838
(513) 424-2111
(513) 420-5662
Mailing address
3180 KETTERING BLVD., ATTENTION DIANE SHANNON, DAYTON, OH 45439-1924
(937) 297-6072
(937) 293-0969
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN129832
OH
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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