MEDICARE: MRS. JANET JEANINE BEARD MSPT

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	100007	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20619019	OTHER	MO	BCBS

General Provider Information

NPI Number	:	1215072954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET JEANINE BEARD MSPT

Provider Business Mailing Address
First Line	:	1213 N BELT HWY
Second Line	:	STE H
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-2485
Country	:	US
Telephone Number	:	816-279-7778
Fax Number	:	816-279-8788

Provider Business Practice Location Address
First Line	:	1213 N BELT HWY STE H
Second Line	:
City	:	SAINT JOSEPH
State	:	MO
Zip	:	64506-2485
Country	:	US
Telephone Number	:	816-279-7778
Fax Number	:	866-245-8064

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	06/26/2017

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