Individual
MICHAEL A BEARDSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1206 SW MAIN BLVD, SUITE 101, LAKE CITY, FL 32025-6684
(386) 752-1652
(386) 752-0939
Mailing address
204 NW EMPORIA GLN, LAKE CITY, FL 32055-8516
(386) 752-0749
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/02/2007
Last updated
10/20/2011
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