Healthcare Provider Details

I. General information

NPI: 1184108680
Provider Name (Legal Business Name): BEAUTIFUL YOU BY DR BETSY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 HAMILTON BLVD
ALLENTOWN PA
18106-9113
US

IV. Provider business mailing address

201 E LAUREL BLVD
POTTSVILLE PA
17901-2534
US

V. Phone/Fax

Practice location:
  • Phone: 610-530-4444
  • Fax: 610-366-1343
Mailing address:
  • Phone: 570-628-4444
  • Fax: 570-628-3088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VANESSA CHRISTMAN
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 570-628-4444