MEDICARE: BEVERLY KAYE HELM PT

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	225100000X	Physical Therapist	6629	CO

General Provider Information

NPI Number	:	1063701134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY KAYE HELM PT

Provider Business Mailing Address
First Line	:	1401 PHAY AVE
Second Line	:
City	:	CANON CITY
State	:	CO
Zip	:	81212-2303
Country	:	US
Telephone Number	:	719-275-8656
Fax Number	:	719-275-8858

Provider Business Practice Location Address
First Line	:	600 DAKOTA LN
Second Line	:
City	:	CANON CITY
State	:	CO
Zip	:	81212-9275
Country	:	US
Telephone Number	:	719-275-8656
Fax Number	:	719-275-8858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2011
Last Update Date	:	03/29/2011

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Directions to “ BEVERLY KAYE HELM PT” Practice Location

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