Individual
TINA LOUISE BEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
19583 N. STATE HWY 130, HIDALGO, IL 62432
(618) 554-5008
Mailing address
19583 N. STATE HWY 130, HIDALGO, IL 62432
(618) 554-5008
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004796
IL
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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