Healthcare Provider Details

I. General information

NPI: 1275972218
Provider Name (Legal Business Name): DAVID RYAN BECKHAM DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VISION DR
ASHEBORO NC
27203-3855
US

IV. Provider business mailing address

400 VISION DR
ASHEBORO NC
27203-3855
US

V. Phone/Fax

Practice location:
  • Phone: 336-672-5450
  • Fax:
Mailing address:
  • Phone: 336-672-5450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP10968
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: