Individual
KEINYA S BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6845 FIVE STAR BLVD STE E, ROCKLIN, CA 95677-2686
(916) 308-2442
Mailing address
6845 FIVE STAR BLVD STE E, ROCKLIN, CA 95677-2686
(916) 308-2442
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
337138
CA
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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