Individual
MR. MICHAEL HOWARD KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
414 CHAPEL ST, MARENGO, IL 60152-3016
(815) 572-1709
Mailing address
414 CHAPEL ST, MARENGO, IL 60152-3016
(815) 572-1709
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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