Individual
KEITH WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1910 SHAFFER ST, KALAMAZOO, MI 49048-1604
(269) 382-9820
Mailing address
1910 SHAFFER ST, KALAMAZOO, MI 49048-1604
(269) 382-9820
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704326901
MI
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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