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Organization
BEACON THERAPIES INC.
Active
Organization
BEACON THERAPIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY PRANGER (CEO/PRESIDENT)
(218) 590-4603
Entity
Organization
Contact information
Practice address
10740 OLD US HIGHWAY 27 S, GAYLORD, MI 49735
(989) 448-2364
Mailing address
1150 ROSENBURG RD NE, KALKASKA, MI 49646-9643
(218) 590-4603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225400000X
Rehabilitation Practitioner
Primary
—
NULL
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/03/2021
Last updated
11/04/2021
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