Provider Demographics
NPI:1922715572
Name:KEENE VISION LLC
Entity Type:Organization
Organization Name:KEENE VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:803-670-5367
Mailing Address - Street 1:1030 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7631
Mailing Address - Country:US
Mailing Address - Phone:803-670-5367
Mailing Address - Fax:
Practice Address - Street 1:1030 ROBIN LN
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7631
Practice Address - Country:US
Practice Address - Phone:803-670-5367
Practice Address - Fax:803-902-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier