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Individual

SHANE A KEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C

Contact information

Practice address
1735 27TH ST STE 102, PORTSMOUTH, OH 45662-2679
(740) 356-8822
(740) 356-8872
Mailing address
1735 27TH ST STE B06, PORTSMOUTH, OH 45662-2681
(740) 356-8681
(740) 353-7900

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005161RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0244969
OH
Enumeration date
10/12/2015
Last updated
05/20/2025
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