Individual
MR. LANCE JEFFREY BEEBOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
111 17TH AVE E STE 101, ALEXANDRIA, MN 56308-3734
(320) 762-1144
(320) 762-1935
Mailing address
111 17TH AVE E STE 101, ALEXANDRIA, MN 56308-3734
(320) 762-1144
(320) 762-1935
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9887
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255300091
—
MN
Enumeration date
03/15/2006
Last updated
10/21/2024
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