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Individual

AUSTIN KEENAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1103 OLD TOWN LN, CHEYENNE, WY 82009-4353
(307) 365-4460
Mailing address
1103 OLD TOWN LN, CHEYENNE, WY 82009-4353
(307) 365-4460

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
07/13/2022
Last updated
07/13/2022
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