Individual
KEVIN BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA, ATC/L
Contact information
Practice address
3813 S MADISON ST, MUNCIE, IN 47302-5758
(765) 751-3300
Mailing address
801 N WALNUT ST, MUNCIE, IN 47305-1458
(765) 747-5270
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06003172
IN
2255A2300X
Athletic Trainer
Primary
36000501A
IN
Other
Enumeration date
10/30/2008
Last updated
07/02/2024
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