Organization
AT MEDICAL DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KEITH KEENE JR. BOCO (CONSULTANT)
(610) 724-3561
Entity
Organization
Contact information
Practice address
45 E CITY LINE AVE, PMB 535, BALA CYNWYD, PA 19004-2421
(610) 724-3561
Mailing address
45 E CITY LINE AVE, PMB 535, BALA CYNWYD, PA 19004-2421
(610) 724-3561
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
OH000301
PA
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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