Healthcare Provider Details

I. General information

NPI: 1275537128
Provider Name (Legal Business Name): MICHAEL BEUOY P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 GOVERNORS DR SW FL 1
HUNTSVILLE AL
35801-5171
US

IV. Provider business mailing address

201 GOVERNORS DR SW FL 1
HUNTSVILLE AL
35801-5171
US

V. Phone/Fax

Practice location:
  • Phone: 256-533-1600
  • Fax: 256-539-0856
Mailing address:
  • Phone: 256-533-1600
  • Fax: 256-539-0856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH3583
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: