Individual
KEENAN ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
425 W UNIVERSITY BLVD, DURANT, OK 74701-3347
(580) 745-3028
Mailing address
425 W UNIVERSITY BLVD, DURANT, OK 74701-3347
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
963
OK
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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