Individual
BILLY KEVIN BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
528 AVENUE F, BOGALUSA, LA 70427-3636
(985) 735-1112
(985) 735-1386
Mailing address
528 AVENUE F, BOGALUSA, LA 70427-3636
(985) 735-1112
(985) 735-1386
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A8335R
LA
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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