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Individual

BRIAN J BEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
106 S MAIN ST, DRY RIDGE, KY 41035-9406
(859) 824-1444
Mailing address
106 S MAIN ST, DRY RIDGE, KY 41035-9406
(859) 824-1444

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
00254
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
80002546
KY
Enumeration date
06/27/2005
Last updated
07/30/2008
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