Angie D Beason

Individual provider Active NPI Physical Therapy Assistant · Jefferson, GA

NPI 1689925604 · NPPES record last updated Oct 1, 2012

Key facts

NPI
1689925604
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1837 (GA)
Practice address
337 Mauldin Rd
Jefferson, GA 30549-1315
Phone
(706) 202-3985
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1837GAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1837 GA Yes

Addresses

Primary practice location

337 Mauldin Rd
Jefferson, GA 30549-1315

Mailing address

337 Mauldin Rd
Jefferson, GA 30549-1315
Phone (706) 202-3985

Other providers in Jefferson, GA

All providers in Jefferson, GA · Physical Therapy Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.