Individual
MR. MICHAEL KEITH KEENE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED ORTHOTIST,
Contact information
Practice address
336 LONEY ST, PHILA, PA 19111-2236
(215) 722-0751
Mailing address
6367 WOODBINE AVE, PHILADELPHIA, PA 19151-2523
(610) 724-3561
(215) 722-0752
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
45OR00006900
NJ
Other
Enumeration date
02/09/2007
Last updated
04/22/2014
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