Individual
KEITH A ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBCHBBAO
Contact information
Practice address
15746 FREMONT WAY, APPLE VALLEY, MN 55124-6531
(715) 205-6789
Mailing address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 234-1515
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036159388
IL
207P00000X
Emergency Medicine Physician
51841
MN
207P00000X
Emergency Medicine Physician
Primary
54561-20
WI
Other
Enumeration date
07/23/2007
Last updated
03/18/2022
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