Individual
MR. PAUL BRYAN BEACHEM IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7400 OLD MAIN HILL, DALE MILDENBERGER SPORTS MEDICINE COMPLEX, LOGAN, UT 84322
(435) 797-3636
Mailing address
7400 OLD MAIN HILL, DALE MILDENBERGER SPORTS MEDICINE COMPLEX, LOGAN, UT 84322
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9067793-4810
UT
2255A2300X
Athletic Trainer
RTO000189
PA
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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