# BEACON THERAPIES INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609531607
- **Authorized official:** COREY PRANGER (CEO/PRESIDENT)
- **Authorized official phone:** (218) 590-4603

## Contact information

- **Practice address:** 10740 OLD US HIGHWAY 27 S, GAYLORD, MI 49735
- **Practice address phone:** (989) 448-2364
- **Mailing address:** 1150 ROSENBURG RD NE, KALKASKA, MI 49646-9643
- **Mailing address phone:** (218) 590-4603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/03/2021
- **Last updated:** 11/04/2021