Individual
MATTHEW THOMAS KEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5000
Mailing address
644 WINTERS EAVE, FLUSHING, MI 48433-1947
(810) 610-2810
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704328616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704328616
REGISTERED NURSE LICENSE
MI
Enumeration date
08/09/2020
Last updated
08/09/2020
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