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NPI Code Detail

MEDICARE: MRS. JENNIFER L BEARD LMT

MEDICARE:  MRS. JENNIFER L BEARD  LMT
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
1225700000XMassage Therapist15719OR

General Provider Information

NPI Number : 1407001159
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER L BEARD LMT
Provider Business Mailing Address
First Line : 915 19TH AVE SE
Second Line :
City : ALBANY
State : OR
Zip : 97322-4228
Country : US
Telephone Number : 541-264-1372
Fax Number :
Provider Business Practice Location Address
First Line : 915 19TH AVE SE
Second Line :
City : ALBANY
State : OR
Zip : 97322-4228
Country : US
Telephone Number : 541-264-1372
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2008
Last Update Date : 11/21/2008

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Directions to “ MRS. JENNIFER L BEARD LMT” Practice Location

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