Organization
BRUCE J KEENAN OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE KEENAN OD (OWNER)
(540) 662-0522
Entity
Organization
Contact information
Practice address
1014 AMHERST ST, SUITE 204, WINCHESTER, VA 22601
(540) 662-0522
Mailing address
1014 AMHERST ST, SUITE 204, WINCHESTER, VA 22601
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009234527
—
VA
Enumeration date
07/08/2008
Last updated
07/08/2008
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