Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ketalityrx PLLC

Organization Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1164110839

Ketalityrx PLLC is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Shelby Twp, Michigan. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

55130 Van Dyke Ave
Shelby Twp, MI 48316-5302
Phone: (586) 207-1624
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X

Record details

NPI number1164110839
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Olafsson — Physician · (248) 495-6066
NPI enumeratedMay 1, 2023
Last updated in NPPESMay 1, 2023
Certification dateApril 29, 2023
Mailing address55130 Van Dyke Ave, Shelby Twp, MI 48316-5302

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