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Benjamin Trace Keaton
Student in an Organized Health Care Education/Training Program in Lewisburg, West Virginia
NPI 1558935015

Benjamin Trace Keaton is a Student in an Organized Health Care Education/Training Program based in Ronceverte, WV. Benjamin Trace Keaton practices in Lewisburg, WV. The NPI Number for Benjamin Trace Keaton is 1558935015 and holds a License No. (West Virginia).

The current practice location address for Benjamin Trace Keaton is 1464 Jefferson St N, Lewisburg, WV and can be reached out via phone at 304-645-3220 and via fax at 304-647-1273.

Location: 1464 Jefferson St N, Lewisburg, WV, 24970-8016
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558935015
Provider Name
Benjamin Trace Keaton
Credential
Provider Entity Type
Individual
Gender
Male
Address
1464 Jefferson St N, Lewisburg, WV, 24970-8016
Phone Number
304-645-3220
Fax Number
304-647-1273
Provider Enumeration Date
05/18/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1464 Jefferson St N
City
Lewisburg
State
West Virginia
Zip
24901-1380
Phone Number
304-645-3220
Fax Number
304-647-1273
person
Provider Business Mailing Address Details
Address
1464 Jefferson St N
City
Lewisburg
State
West Virginia
Zip
24901-1380
Phone Number
304-645-3220
Fax Number
304-647-1273
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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