Individual
DR. MICHAEL RYAN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2936 E 79TH AVE, MERRILLVILLE, IN 46410-5748
(219) 947-1052
Mailing address
324 S BOO RD, APT 101, BURNS HARBOR, IN 46304-0040
(219) 508-4728
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003293A
IN
Other
Enumeration date
04/11/2006
Last updated
07/08/2015
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