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Individual

STACIE IREEN BEYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
772 FOXCROFT AVE # 14, MARTINSBURG, WV 25401-1838
(304) 262-8161
(304) 262-6061
Mailing address
772 FOXCROFT AVE # 14, MARTINSBURG, WV 25401-1838
(304) 262-8161
(304) 262-6061

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001680
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9350561
MEDICARE P10
WV
Enumeration date
09/07/2011
Last updated
09/07/2011
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