Individual
EVA MARIE BEAULIEU
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
601 BROAD ST, LAGRANGE, GA 30240-2955
(770) 722-4054
Mailing address
130 BRIERWOOD CT, FAYETTEVILLE, GA 30215-4615
(770) 722-4054
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001195
GA
Other
Enumeration date
06/24/2006
Last updated
07/08/2007
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