Individual
GREGORY ROYCE BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
2501 CAPEHART RD, OFFUTT A F B, NE 68113-1043
(402) 294-9429
(402) 232-1644
Mailing address
2501 CAPEHART RD, OFFUTT A F B, NE 68113-1043
(402) 294-9429
(402) 232-1644
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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