MEDICARE: BEAMANS WELLNESS CENTER P C

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	261Q00000X	Clinic/Center	MD 17645	OR

General Provider Information

NPI Number	:	1326221227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAMANS WELLNESS CENTER P C

Provider Business Mailing Address
First Line	:	1903 AUSTIN ST STE B
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-5404
Country	:	US
Telephone Number	:	541-885-9989
Fax Number	:	541-885-7998

Provider Business Practice Location Address
First Line	:	1903 AUSTIN ST STE B
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-5404
Country	:	US
Telephone Number	:	541-885-9989
Fax Number	:	541-885-7998

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JONI L BEAMAN
Credential	:
Telephone Number	:	541-885-9989

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	01/03/2008

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