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Individual

CHAZ CARROL BECKWITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
117 W 6TH ST, LARNED, KS 67550-3045
(620) 285-6011
Mailing address
315 RUSH AVE, LARNED, KS 67550-3445
(620) 357-1629

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03808
KS

Other

Enumeration date
04/28/2021
Last updated
04/28/2021
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