Provider Demographics
NPI:1083835763
Name:KEENAN, WILLIAM CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:KEENAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 WEST RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468
Mailing Address - Country:US
Mailing Address - Phone:610-495-0101
Mailing Address - Fax:
Practice Address - Street 1:533 WEST RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468
Practice Address - Country:US
Practice Address - Phone:610-495-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005694L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU49402Medicare UPIN