MEDICARE: DONALD JAMES KEENAN P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-005937-L	PA

General Provider Information

NPI Number	:	1275535783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD JAMES KEENAN P.T.

Provider Business Mailing Address
First Line	:	7 NORTHRIDGE DR E
Second Line	:
City	:	MOHNTON
State	:	PA
Zip	:	19540-1262
Country	:	US
Telephone Number	:	610-777-0407
Fax Number	:	610-372-0966

Provider Business Practice Location Address
First Line	:	1510 CORNWALL RD
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7479
Country	:	US
Telephone Number	:	717-454-0061
Fax Number	:	717-454-0062

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	05/02/2017

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