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NPI Code Detail

MEDICARE: MARK BEATY

MEDICARE: MARK BEATY
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1245607639
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK BEATY
Provider Business Mailing Address
First Line : 1805 N SCOTTSDALE RD
Second Line :
City : TEMPE
State : AZ
Zip : 85281-1556
Country : US
Telephone Number : 480-941-4169
Fax Number : 480-782-5213
Provider Business Practice Location Address
First Line : 1805 N SCOTTSDALE RD
Second Line :
City : TEMPE
State : AZ
Zip : 85281-1556
Country : US
Telephone Number : 480-941-4169
Fax Number : 480-782-5213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2015
Last Update Date : 09/01/2015

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Directions to “ MARK BEATY ” Practice Location

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