Individual
JIMMY KEATON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
Mailing address
821 ODD ROAD, GHENT, WV 25843
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4504
WV
Other
Enumeration date
08/13/2014
Last updated
08/13/2014
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