Individual
MICHAEL KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6785 MYERS LAKE AVE NE, SUITE C, ROCKFORD, MI 49341-7416
(616) 874-8772
Mailing address
4310 LEONARD ST NW, SUITE 103, GRAND RAPIDS, MI 49534-8447
(616) 453-6329
(616) 453-1725
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001533
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2751473
—
MI
Enumeration date
08/22/2006
Last updated
10/12/2009
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