Organization
KEITH FAMILY VISION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALLEN KEITH O.D. (PRESIDENT)
(423) 283-7300
Entity
Organization
Contact information
Practice address
119 BOONE RIDGE DR, SUITE 101, JOHNSON CITY, TN 37615-4998
(423) 283-7300
(423) 283-4729
Mailing address
119 BOONE RIDGE DR, SUITE 101, JOHNSON CITY, TN 37615-4998
(423) 283-7300
(423) 283-4729
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T1320
TN
152W00000X
Optometrist
T1679
TN
Other
Enumeration date
03/07/2007
Last updated
09/03/2010
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