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Individual

DAVID KEENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
460 MARKET ST STE 208, WILLIAMSPORT, PA 17701-6322
(570) 419-2779
Mailing address
619 WYOMING ST, WILLIAMSPORT, PA 17701-3550
(570) 419-2779

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG001962
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
76-0749020
PA
Enumeration date
05/04/2015
Last updated
05/04/2015
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