Individual
DR. ELISE N KETELAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(947) 521-8136
Mailing address
1825 PARMENTER BLVD APT 312, ROYAL OAK, MI 48073-1268
(231) 580-3103
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5151016385
MI
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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