Individual
WANDA BEACHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4200 WASHINGTON ST, HOLLYWOOD, FL 33021-7353
(954) 266-3042
(954) 266-3043
Mailing address
4200 WASHINGTON ST, HOLLYWOOD, FL 33021-7353
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
23362
FL
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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