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1104541556
KEATON WARE
DEARBORN, MI
NPI
1104541556
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601011362)
Enumeration Date
2022-10-07
Last Update Date
2022-11-14
Business Address
KEATON WARE PA-C
23455 MICHIGAN AVE
DEARBORN, MI 48124-1908
Phone number: 734-333-8001
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Mailing Address
KEATON WARE PA-C
1301 ORLEANS ST APT 1905E
DETROIT, MI 48207-3098
Phone number: 989-600-9668
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