Provider Demographics
NPI:1942470745
Name:KELLER, RONALD DALE II
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DALE
Last Name:KELLER
Suffix:II
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:DALE
Other - Last Name:KELLER
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5887 HIGH POINT CT
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8065
Mailing Address - Country:US
Mailing Address - Phone:810-360-8135
Mailing Address - Fax:
Practice Address - Street 1:8589 W GRAND RIVER AVE
Practice Address - Street 2:DUNCAN CHIROPRACTIC GROUP P.C. SUITE F
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-4335
Practice Address - Country:US
Practice Address - Phone:810-360-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor