Organization
ALWAYS ACTIVE ASSESSMENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA P. BEASOCK (PHYSICAL THERAPIST)
(315) 376-3728
Entity
Organization
Contact information
Practice address
7609 BAKER RD, LOWVILLE, NY 13367-2509
(315) 376-3728
Mailing address
7609 BAKER RD, LOWVILLE, NY 13367-2509
(315) 376-3728
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008822-1
NY
225X00000X
Occupational Therapist
4293
NY
235Z00000X
Speech-Language Pathologist
008541-1
NY
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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