Provider Demographics
NPI:1346659281
Name:KEENER, VIRGINIA (LMT)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:KEENER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 W VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-6741
Mailing Address - Country:US
Mailing Address - Phone:304-376-2069
Mailing Address - Fax:
Practice Address - Street 1:668 W VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-6741
Practice Address - Country:US
Practice Address - Phone:304-376-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2009-2630174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist