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Individual
TYLER BEAUCHAMP
Active
Individual
TYLER BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, ATC
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
105325
IA
2255A2300X
Athletic Trainer
Primary
080342
IA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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