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Individual

JOHN BEEH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3251
(208) 962-2313
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 962-3251
(208) 962-2313

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-83
ID
363A00000X
Physician Assistant
Primary
PA83
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
805028800
ID
Enumeration date
06/14/2005
Last updated
08/05/2021
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