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Individual

MR. KIM DUANE KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BC-HIS

Contact information

Practice address
1549 POTOMAC AVE, HAGERSTOWN, MD 21742-2930
(301) 797-2344
(240) 625-9449
Mailing address
1549 POTOMAC AVE, HAGERSTOWN, MD 21742-2930
(301) 797-2344
(240) 625-9449

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1581
MD

Other

Enumeration date
09/16/2009
Last updated
11/11/2016
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