Individual
MR. JOSEPH STEVEN BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
12138 S MAIN ST, TRENTON, GA 30752-5151
(706) 657-2700
(706) 657-7965
Mailing address
PO BOX 942, TRENTON, GA 30752-0942
(706) 657-2700
(706) 657-7965
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA0000000881
TN
225200000X
Physical Therapy Assistant
Primary
PTA000430
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3110918
BCBS OF TENNESSEE
TN
01
—
4978909
CIGNA OF TENNESSEE
TN
01
—
5100496100
BCBS OF GEORGIA
GA
01
—
6109965001
CIGNA OF GEORGIA
GA
Enumeration date
06/26/2006
Last updated
07/08/2007
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