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General NPI Number Information
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NPI Number | 1295739761
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Entity Type | Individual
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Provider Name | ERIC A BEARD P.T.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2005
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 1900 LOCUST AVE SUITE A
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City | FAIRMONT
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State | WV
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Zip | 26554-1239
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Country | US
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Telephone | 304-225-5222
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Fax | 304-333-5224
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Provider Business Mailing Address
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Address Line | 150 MEMORIAL DR
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City | KINGWOOD
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State | WV
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Zip | 26537-1141
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Country | US
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Telephone | 304-329-3908
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Fax | 304-329-3918
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 001561
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License Number State | WV
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