Provider Demographics
NPI:1477580066
Name:KEEN, RONALD DOUGLAS II (ATC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:DOUGLAS
Last Name:KEEN
Suffix:II
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11910 ANDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DAVISBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48350-3027
Mailing Address - Country:US
Mailing Address - Phone:248-980-4484
Mailing Address - Fax:
Practice Address - Street 1:800 W AVON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2704
Practice Address - Country:US
Practice Address - Phone:248-218-2148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer