Organization
AMY M. KELLER OD PC
Active
Parent organization
AMY M. KELLER OD PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMY M. KELLER OD PC
Authorized official
DR. AMY M KELLER OD (PRESIDENT)
(231) 832-3133
Entity
Organization
Contact information
Practice address
115 W UPTON AVENUE, REED CITY, MI 49677-1129
(231) 832-3133
(231) 832-1417
Mailing address
115 W UPTON AVENUE, REED CITY, MI 49677-1129
(231) 832-3133
(231) 832-1417
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AK003308
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0289080001
ADMINISTAR FEDERAL, INC
MI
01
—
0N43890
MEDICARE ID
MI
01
—
1184727612
DR. WILSON'S PERSONAL NPI
MI
01
—
1336259761
DR. KELLER'S PERSONAL NPI
MI
05
—
2883730
—
MI
Enumeration date
03/20/2007
Last updated
06/29/2013
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