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Individual

PETER J. KEENAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1149 SULLIVAN ST, ELMIRA, NY 14901
Mailing address
1149 SULLIVAN ST, ELMIRA, NY 14901
(607) 734-2006

Taxonomy

Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225C00000X
NY
Enumeration date
02/06/2018
Last updated
02/06/2018
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