Individual
TONYA JEAN KEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 PAVILION DR, KINGSPORT, TN 37660-4622
(423) 765-9655
Mailing address
PO BOX 1182, RAVEN, VA 24639-1182
(276) 971-4567
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA0000001446
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA0000001446
OCCUPATIONAL THERAPY ASSISTANT
TN
Enumeration date
02/09/2020
Last updated
02/09/2020
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