Individual
MICHAEL J KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
132 5TH AVE W STE 1, JEROME, ID 83338-1825
(208) 814-9800
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRO-2241
ID
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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