Individual
MRS. JENNY COHAN BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1967 LAKESIDE PKWY, SUITE 420, TUCKER, GA 30084-5867
(770) 414-0055
(770) 414-0045
Mailing address
1343 PEACHTREE BATTLE AVE NW, ATLANTA, GA 30327-1423
(404) 351-2480
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT007659
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918546041B
—
GA
Enumeration date
12/21/2006
Last updated
09/27/2013
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