Individual
DR. JENNIFER REBECCA KEADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
406 N BROADWAY AVE, BURNS, OR 97720-1551
(541) 573-1575
Mailing address
406 N BROADWAY AVE, BURNS, OR 97720-1551
(541) 573-1575
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3103T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231403
—
OR
Enumeration date
03/21/2006
Last updated
07/23/2015
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