Provider Demographics
NPI:1558777219
Name:KEENA, BRENDAN JAMES CHRISTOPHER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:JAMES CHRISTOPHER
Last Name:KEENA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4017
Mailing Address - Country:US
Mailing Address - Phone:443-964-6348
Mailing Address - Fax:443-964-6359
Practice Address - Street 1:2987 PLAZA DR
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-2735
Practice Address - Country:US
Practice Address - Phone:443-964-6348
Practice Address - Fax:443-964-6359
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist