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Individual

BRUCE J KEENAN SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1014 AMHERST ST, STE 204, WINCHESTER, VA 22601-3308
(540) 662-0522
(540) 662-6368
Mailing address
1014 AMHERST ST, STE 204, WINCHESTER, VA 22601-3308
(540) 662-0522
(540) 662-6368

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000730
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009234527
VA
Enumeration date
12/20/2005
Last updated
07/08/2008
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