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NPI Code Detail

MEDICARE: NICHOLAS ANDREW BEACH DPT

MEDICARE: NICHOLAS ANDREW BEACH DPT
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 Therapist05016414AIN

General Provider Information

NPI Number : 1336073519
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS ANDREW BEACH DPT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1992 E STOP 13 RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-6267
Country : US
Telephone Number : 317-808-0230
Fax Number : 317-808-0231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

Similar Medicare Providers

1346413697 — JENNIFER LYNN CHRISTIE MSOT, OTR/L
Practice Location Address:
1992 E STOP 13 RD
INDIANAPOLIS, IN
46227-6267
Practice Phone: 317-808-0230
Practice Fax: 317-808-0231
1598732026 — MARY E OURSLER P.T.
Practice Location Address:
1992 E STOP 13 RD
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1427019900 — TAMARA S THIEDE P.T.
Practice Location Address:
1992 E STOP 13 RD
INDIANAPOLIS, IN
46227-6267
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Practice Fax: 317-808-0231
1326002460 — ANTHONY JAMES CARDEN PTA
Practice Location Address:
1992 E STOP 13 RD
INDIANAPOLIS, IN
46227-6267
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Practice Fax:
1871558411 — JULIE ANN PARENT PTA
Practice Location Address:
1992 E STOP 13 RD
INDIANAPOLIS, IN
46227-6267
Practice Phone: 317-808-0230
Practice Fax:
1639337751 — JOHANNA ELIZABETH LASSITER D.P.T.
Practice Location Address:
1992 E STOP 13 RD
INDIANAPOLIS, IN
46227-6267
Practice Phone: 317-808-0230
Practice Fax: 317-808-0231

Directions to “ NICHOLAS ANDREW BEACH DPT” Practice Location

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