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NPI Code Detail

MEDICARE: AMY BEAHAN

MEDICARE: AMY BEAHAN
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
1225200000XPhysical Therapy Assistant1059NC

General Provider Information

NPI Number : 1578910402
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY BEAHAN
Provider Business Mailing Address
First Line : 202 HEPWORTH WAY
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-3155
Country : US
Telephone Number : 910-547-7510
Fax Number : 910-792-1492
Provider Business Practice Location Address
First Line : 5725 CAROLINA BEACH RD
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-2611
Country : US
Telephone Number : 910-792-1455
Fax Number : 910-792-1492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2016
Last Update Date : 05/20/2016

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Directions to “ AMY BEAHAN ” Practice Location

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