Keenan, Bruce J

Keenan, Bruce J is an sole proprietor health care provider with primary practice located at 1014 Amherst St Ste 204, Winchester VA 22601-3308. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Keenan, Bruce J can be contacted via phone (540) 662-0522.

Contact Information

Primary practice address
1014 Amherst St Ste 204 Winchester VA 22601-3308
Fax: (540) 662-6368
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618000730 Virginia

Profile Details

NPI number 1932185022
LBN Legal business name Keenan, Bruce J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2005
Last updated Jul 8th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932185022 NPPES
Virginia MEDICAID 009234527

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